Su1666 Clinical Outcomes for Neuroendocrine Tumors of the Duodenum and Ampulla of Vater: A Population-Based Study

Randle, Reese W.; Ahmed, Shuja; Newman, Naeem A.; Clark, Clancy J.

doi:10.1016/s0016-5085(13)64048-2

Cited by 17 publications

(36 citation statements)

References 20 publications

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“…The mean age (63.5 vs. 57 years), mean mitotic count (1/10 HPF), Ki67 (1%) and grade of the tumor (NET G1) were comparable with the study done by Ishido et al (9). The clinical course of the ampullary NETs are different from duodenal NETs, as they have a more aggressive phenotype, with generally higher-grade tumor (10).…”

Section: Similar To Our Study Maggard Et Al and Modlin Et Alsupporting

confidence: 83%

Clinicopathologic study of neuroendocrine tumors of gastroenteropancreatic tract: a single institutional experience

Uppin¹,

Uppin²,

Sunil³

et al. 2017

J. Gastrointest. Oncol.

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Background: The gastroenteropancreatic neuroendocrine tumors (GEPNET) have a characteristic histologic appearance unrelated of the exact site of origin. However the behavior of these tumors are different in each of these sites. In this article we study the clinicopathological features of GEPNET. These tumors were classified and graded according to WHO 2010 criteria. The immunohistochemical (IHC) features were evaluated and the grade of the tumor was correlated with Ki67.Methods: A total of 40 cases of GEPNET diagnosed on biopsies as well as resected specimens were analyzed from January 2012 to June 2015.Results: There were 28 resected specimens and 12 biopsies. Majority of the gastric neuroendocrine tumors (NET) showed classic morphology of cells arranged in islands. There were 3 cases each of grade 1 and grade 2 and one was diagnosed as mixed adenoneuroendocrine carcinoma (MANEC). All the duodenal NET were well differentiated (grade 1). There were 8 cases in colon and rectum, of which 4 cases were grade 3 and 3 cases were grade 2. Majority of the pancreatic tumors were grade 1. The mean mitotic count along with ki67 had good correlation in NET of stomach, duodenum colon and rectum. Conclusions:The most common site was small intestine followed by pancreas. Majority of the tumors were NET G1. Tumors from colorectal region were mostly NEC G3. There was a strong correlation by spearman correlation analysis between Ki67 and mitotic count and moderate correlation between ki67 and tumor grade as well as mitotic rate and tumor grade. Ki67 was helpful in grading these tumors.

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Section: Similar To Our Study Maggard Et Al and Modlin Et Alsupporting

confidence: 83%

Clinicopathologic study of neuroendocrine tumors of gastroenteropancreatic tract: a single institutional experience

Uppin¹,

Uppin²,

Sunil³

et al. 2017

J. Gastrointest. Oncol.

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“…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.…”

Section: Discussionmentioning

confidence: 89%

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

Gamboa

Liu

Lee

et al. 2019

Journal of Surgical Oncology

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Background While sub‐2 cm pancreatic neuroendocrine tumors (NETs) are often observed, small bowel‐NETs undergo resection and lymphadenectomy regardless of size. Aim was to define the natural history of duodenal (D‐NETs), determine the role of resection, and define the factors associated with overall survival (OS) after resection. Methods National Cancer Database (2004‐2014) was queried for the patients with nonmetastatic/nonfunctional D‐NETs. Local resection (LR): local excision/polypectomy/excisional biopsy. Anatomic resection (AR): radical surgery. Tumor size was divided into less than 1 cm, 1 to 2 cm, and ≥2 cm. Propensity score weighting was used to create balanced resection and no‐resection cohorts. The primary endpoint was OS. Results Among 5502 patient, the median age was 65 years. The median follow‐up was 49 months. The median tumor size was 0.8 cm. Resection was performed in 72% (n = 3954; LR: 61%, AR: 39%). Lymph node (LN) resection was performed in 26% (43% had metastasis). A total of 74% had negative margins. Resection and no‐resection cohorts were propensity score weighted for age/sex/race/Charlson‐Deyo score/tumor grade (all independently associated with OS on multivariable analysis). Resection was associated with improved median OS compared to no resection in all sizes (<1 cm: median not reached vs 194 months; 1‐2 cm: median not reached vs 56 months; >2 cm: median not reached vs 90 months; all P < .01). Subset analysis of each resection size cohort demonstrated that neither type of resection, LN retrieval, LN positivity, or margin status was associated with OS (all P > .05). Conclusion Patients with nonmetastatic and nonfunctional D‐NETS should be considered for resection regardless of tumor size. Given the lack of prognostic value, the resection type and extent of LN retrieval should be tailored to each patient's clinical picture and safety profile.

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“…There was a concomitant decrease in the presentation of patients with stage IV disease, from almost 20% 24 using a similar cohort of 1,360 patients from the SEER registry, noted a similarly excellent median survival of 143 months. 23 In addition, we found an improved 5-year survival for patients presenting after 2006 (85.2 vs 89.6%).…”

Section: Discussionmentioning

confidence: 92%

Increasing incidence of duodenal neuroendocrine tumors: Incidental discovery of indolent disease?

Fitzgerald

Dennis

Kachare

et al. 2015

Surgery

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Su1666 Clinical Outcomes for Neuroendocrine Tumors of the Duodenum and Ampulla of Vater: A Population-Based Study

Cited by 17 publications

References 20 publications

Clinicopathologic study of neuroendocrine tumors of gastroenteropancreatic tract: a single institutional experience

Clinicopathologic study of neuroendocrine tumors of gastroenteropancreatic tract: a single institutional experience

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

Increasing incidence of duodenal neuroendocrine tumors: Incidental discovery of indolent disease?

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