Heterogeneity of Duodenal Neuroendocrine Tumors: An Italian Multi-center Experience

Abstract

dNENs prognosis may be highly variable. These tumors can be metastatic in up to 50% of cases at the time of first diagnosis and can develop metastases thereafter. Functioning neoplasms express high metastatic potential. Nuclear imaging should be performed to exclude distant metastases in all dNENs. Endoscopy and surgery play a primary role in the management of the disease. Further prospective studies are needed.

Duodenal neuroendocrine tumors: Somewhere between the pancreas and small bowel?

“…In addition, although tumor size was ≥2 cm was associated with worse OS on univariate analysis, this finding did not persist in a multivariable model. It should be noted, however, that although a large proportion of the tumors in this series were well differentiated, poorly differentiated tumor grade was an independent predictor of outcome, a finding that has been illustrated universally and is a surrogate for tumor biology …”

“…Neither type of resection nor margin status was predictive of improved OS. Other investigators have also reported on the type of procedure used for resection and have not found an association with long‐term outcomes . These findings highlight that although there is a clear indication to achieve local control with resection of the primary tumor, survival may not be affected by extent of resection largely due to the indolent nature of this disease.…”

“…It should be noted, however, that although a large proportion of the tumors in this series were well differentiated, poorly differentiated tumor grade was an independent predictor of outcome, a finding that has been illustrated universally and is a surrogate for tumor biology. 1,30,38 Note: For multivariable analysis, backward selection with an α level of removal of 0.2 was used. Abbreviations: CI, confidence interval; HR, hazard ratio.…”

“…Other investigators have also reported on the type of procedure used for resection and have not found an association with long-term outcomes. 1,33,38 These findings Note: For multivariable analysis, backward selection with an α level of removal of 0.2 was used. Estimated stratified treatment effect was controlled by the following: age at diagnosis, sex, race, Charlson-Deyo score, and tumor grade Abbreviations: AR, anatomic resection; CI, confidence interval; HR, hazard ratio; LR, local resection.…”

Duodenal neuroendocrine tumors: Impact of tumor size and total number of lymph nodes examined

“…The impact of not staging the nodal basin in the setting of endoscopic excision remains poorly defined. Unfortunately, data on the clinical characteristics, tumor biology, treatment, and prognosis of patients with dNETs have been limited largely to small, single‐center case series . Therefore, the objective of the current study was to define the outcomes of patients who underwent curative‐intent resection for periampullary and nonampullary dNETs using a large, multi‐institutional database.…”