Multiple Gastric G1 Neuroendocrine Tumors with Venous and Lymphatic Invasion

Tatsuta, Tetsuya; Yoshimura, Teizo; Hasui, Keisuke; Takasugi, Kaori; Sawaya, Manabu; Hanabata, Norihiro; Shimoyama, Tadashi; Kijima, Hiroshi; Fukuda, Shinsaku

doi:10.2169/internalmedicine.52.0083

Cited by 4 publications

(4 citation statements)

References 13 publications

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“…Neuroendocrine tumors (NETs) were diagnosed following the new histologic grading system of the 2010 World Health Organization classification for digestive system NETs [17, 18]. …”

Section: Histological Assessmentmentioning

confidence: 99%

Feasibility of Endoscopy-Assisted Laparoscopic Full-Thickness Resection for Superficial Duodenal Neoplasms

Ohata

Murakami

Yamazaki

et al. 2014

The Scientific World Journal

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Background. Superficial duodenal neoplasms (SDNs) are a challenging target in the digestive tract. Surgical resection is invasive, and it is difficult to determine the site and extent of the lesion from outside the intestine and resect it locally. Endoscopic submucosal dissection (ESD) has scarcely been utilized in the treatment of duodenal tumors because of technical difficulties and possible delayed perforation due to the action of digestive juices. Thus, no standard treatments for SDNs have been established. To challenge this issue, we elaborated endoscopy-assisted laparoscopic full-thickness resection (EALFTR) and analyzed its feasibility and safety. Methods. Twenty-four SDNs in 22 consecutive patients treated by EALFTR between January 2011 and July 2012 were analyzed retrospectively. Results. All lesions were removed en bloc. The lateral and vertical margins of the specimens were negative for tumor cells in all cases. The mean sizes of the resected specimens and lesions were 28.9 mm (SD ± 10.5) and 13.3 mm (SD ± 11.6), respectively. The mean operation time and intraoperative estimated blood loss were 133 min (SD ± 45.2) and 16 ml (SD ± 21.1), respectively. Anastomotic leakage occurred in three patients (13.6%) postoperatively, but all were minor leakage and recovered conservatively. Anastomotic stenosis or bleeding did not occur. Conclusions. EALFTR can be a safe and minimally invasive treatment option for SDNs. However, the number of cases in this study was small, and further accumulations of cases and investigation are necessary.

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“…Neuroendocrine tumors (NETs) were diagnosed following the new histologic grading system of the 2010 World Health Organization classification for digestive system NETs [17, 18]. …”

Section: Histological Assessmentmentioning

confidence: 99%

Feasibility of Endoscopy-Assisted Laparoscopic Full-Thickness Resection for Superficial Duodenal Neoplasms

Ohata

Murakami

Yamazaki

et al. 2014

The Scientific World Journal

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“…This approach is supported by some reports [24,[38][39][40] which suggest that careful endoscopic follow-up might represent a reasonable safe option in selected patients. However, further studies evaluating larger cohorts during a longer follow-up period are necessary in order to support this clinical behavior, as some cases of progressive malignant GC1s have already been reported [17][18][19]41] . Accordingly, the ENETS guidelines recommend endoscopic resection whenever possible, even in the presence of small carcinoids (diameter < 1 cm ø) and for up to 6 polyps not involving the muscularis propria [8] .…”

Section: Management Of Type-i Gastric Carcinoid -A Clinical Challengementioning

confidence: 99%

“…Moreover, the evolution to neuroendocrine carcinoma may occur in 3% of patients [15] . Nevertheless, local or distant metastases have been reported also in patients affected by GC1s with low proliferation index (< 2%), small size and exclusive intramucosal invasion [16][17][18][19] . In addition, GC1s frequently recur (5%-67% of cases after endoscopic treatment) [20,21] , with a median recurrence-free time interval of 24 mo after endoscopic resection.…”

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confidence: 99%

Somatostatin analogs for gastric carcinoids: For many, but not all

Massironi

Zilli

Conte

2015

WJG

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“…3,[21][22][23][24] With larger lesions, endoscopic mucosal resection or endoscopic submucosal dissection (ESD) can be used to maximize complete endoscopic resection rates, 3,20,23,25 if there is no muscularis propria invasion. 20,[26][27][28] Surgical resection is generally recommended in the case of involvement of the muscularis propria and/or local lymph nodes documented by ultrasound endoscopy. 3,20,26 However, gNET-1s often represent a multifocal and recurring disease and, in cases of multiple (6 lesions), recurrent, partially invasive (beyond submucosa), > 2 cm sized tumors, guidelines are lacking and not as univocal.…”

Section: Introductionmentioning

confidence: 99%

Response and relapse rates after treatment with long‐acting somatostatin analogs in multifocal or recurrent type‐1 gastric carcinoids: A systematic review and meta‐analysis

Rossi¹,

Invernizzi

Mazzaferro³

et al. 2020

UEG Journal

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Background Type-1 gastric neuroendocrine tumors represent a recurring disease and long-acting somatostatin analogs can inhibit both gastrin release and endocrine cell proliferation. The efficacy and timing of this treatment are still unclear. We performed a systematic review of the literature to clarify the role of somatostatin analog treatment in type-1 gastric neuroendocrine tumors. Methods A computerized literature search was performed using relevant keywords to identify all the pertinent articles published in the last 15 years. Results Eight studies were included in this systematic review on somatostatin analogs in type-1 gastric neuroendocrine tumors. A complete response rate ranged from 25–100%. When only the six prospective studies were considered, no significant heterogeneity was observed, and the pooled cumulative complete response rate was 84.5% (confidence interval 73.8–92.8). Three studies evaluated the type-1 gastric neuroendocrine tumor recurrence, with a cumulative relapse rate of 30.2% (confidence interval 13.1–50.6) after 34 months. Conclusion Somatostatin analogs, namely lanreotide and octreotide, have an excellent response rate, with a good safety profile in selected type-1 gastric neuroendocrine tumors, which cannot be safely managed by endoscopic follow-up or resection due to multiple or frequently recurring disease. After therapy discontinuation, the cumulative relapse rate observed after a median 34-month follow-up was relatively high (30.2%).

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Multiple Gastric G1 Neuroendocrine Tumors with Venous and Lymphatic Invasion

Cited by 4 publications

References 13 publications

Feasibility of Endoscopy-Assisted Laparoscopic Full-Thickness Resection for Superficial Duodenal Neoplasms

Feasibility of Endoscopy-Assisted Laparoscopic Full-Thickness Resection for Superficial Duodenal Neoplasms

Somatostatin analogs for gastric carcinoids: For many, but not all

Response and relapse rates after treatment with long‐acting somatostatin analogs in multifocal or recurrent type‐1 gastric carcinoids: A systematic review and meta‐analysis

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