Surgical treatment for gastrointestinal neuroendocrine tumors

Eto, Kojiro; Yoshida, Naoya; Iwagami, Shiro; Iwatsuki, Masaaki; Baba, Hideo

doi:10.1002/ags3.12396

Cited by 22 publications

(34 citation statements)

References 61 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…[ 49 ] In the presence of metastases, cytoreduction surgery is recommended to control symptoms and hormonal hypersecretion. [ 50 ] Octreotide showed good results in tumors regression in ZES or MEN-1. [ 51 ] Pancreaticoduodenectomy with total gastrectomy were performed in patient with type 2 gastric NET (case 2).…”

Section: Discussionmentioning

confidence: 99%

Gastric neuroendocrine neoplasms and precursor lesions

et al. 2022

View full text Add to dashboard Cite

Rationale: Gastric neuroendocrine neoplasms (g-NENs) represent a distinctive group of gastric tumors, stratified into different prognostic categories according to different histological characteristics, put forth in the 2018 World Health Organization classification system. The clinical presentations, as well as pathological features, represent important data in establishing the type of the tumor, in estimating the tumor behavior, and in selecting the best therapeutic strategy. In our case series we presented different clinical scenarios that may be encountered in practice regarding gastric NENs. We performed a literature review and discussed diagnostic strategy, current classification system, precursor lesions, and therapeutic options in g-NENs. Patient concerns: The first patient was a 41-year-old female with weight loss, persistent dyspeptic complaints and a history of pernicious anemia. In the second clinical case a 61-year-old man was admitted with heartburn, abdominal pain, diarrhea and mild iron deficiency anemia. The third patient was a 56-year-old male with a history of neoplasia, admitted for weight loss, dyspeptic complaints, and liver metastases. Diagnosis: All the 3 patients underwent upper endoscopy with targeted biopsies. Histopathological and laboratory evaluation, together with imagistic evaluation (abdominal ultrasound, endoscopic ultrasound, and magnetic resonance imaging) allowed the distinction between 3 different types of gastric tumors: type 1 enterochromaffin-like-cell G1 NET, type 2 enterochromaffin-like-cell G2 NET, and type 3 G2 NET with liver metastases. Interventions: Endoscopic polypectomy of the largest lesion was performed in patient with type 1 g-NET and autoimmune chronic atrophic gastritis, followed by regular endoscopic surveillance with biopsies. In type 2 g-NET associated with pancreatic gastrinoma, pancreaticoduodenectomy with total gastrectomy were performed. In type 3 g-NET, detected in metastatic stage, oncologic therapy was performed. Outcomes: The patients follow-up was selected according to tumor behavior, from regular endoscopic surveillance to oncology follow-up. The prognosis was good in case 1, whilst poorer outcomes were associated with more aggressive tumors in case 2 and case 3. Lessons: g-NENs are rare tumors with distinct clinical and histological features. Our case series emphasized the role of close collaboration between clinician and pathologist, as well as the importance of a detailed pathology report.

show abstract

Section: Discussionmentioning

confidence: 99%

Gastric neuroendocrine neoplasms and precursor lesions

et al. 2022

View full text Add to dashboard Cite

show abstract

“…-in the case of tumours of < 1 cm in size, follow-up or endoscopic removal is admissible. -resection of lesions of ≥ 1 cm in size or lesions infiltrating the muscularis propria is recommended [5,61]. Endoscopic submucosal dissection (ESD) is the recommended method of removing submucosal lesions because it enables the removal of the lesion en bloc with complete histopathological examination [61,62].…”

Section: Typementioning

confidence: 99%

Gastroduodenal neuroendocrine neoplasms including gastrinoma — update of the diagnostic and therapeutic guidelines (recommended by the Polish Network of Neuroendocrine Tumours) [Nowotwory neuroendokrynne żołądka i dwunastnicy z uwzględnieniem gastrinoma — uaktualnione zasady postępowania (rekomendowane przez Polską Sieć Guzów Neuroendokrynnych)]

et al. 2022

View full text Add to dashboard Cite

This article is available in open access under Creative Common Attribution-Non-Commercial-No Derivatives 4.0 International (CC BY-NC-ND 4.0) license, allowing to download articles and share them with others as long as they credit the authors and the publisher, but without permission to change them in any way or use them commercially  456 Guidelines Grażyna Rydzewska et al. Guidelinesin the World Health Organization (WHO) and North American Neuroendocrine Tumor Society (NANETS) recommendations [12, 13] (Tab. 1). PathogenesisType 1 and type 2 tumours develop from enterochromaffin-like (ECL) cells in the gastric mucosa in response to chronic oversecretion of gastrin. Secondary hypergastrinaemia -caused by achlorhydria in the course of chronic atrophic gastritis (CAG) --is responsible for the development of GNEN type 1. Primary hypergastrinaemia -in Zollinger-Ellison syndrome (ZES), sporadic or associated with multiple endocrine neoplasia 1 (MEN-1) --is responsible for GNEN type 2. Gastrin and its derivatives stimulate the proliferation, migration, and differentiation of ECL cells, which in turn leads to their hyperplasia and dysplasia. Hypergastrinaemia, without the interaction of the transforming factor/factors, does not cause the development of GNEN [4]. Menin dysfunction may constitute a transforming factor in patients with MEN-1. The literature also mentions other factors including the following: BCL2 apoptosis inhibiting protein, p53 protein, fibroblast growth factor (FGF), transforming growth factor (TGF), Regla protein dysfunction (inhibiting the proliferation of ECL cells) [14]. Type 1Gastric neuroendocrine neoplasms type 1 (70-80% GNEN) occur in patients with atrophic gastritis. They

show abstract

“…Indications for endoscopic treatment are determined by the grade, depth, and size of the tumor. For localized tumors that are not indicated for endoscopic resection, the indication for surgical resection is determined based on whether the metastatic lesion can be completely resected [8,12,13]. Thus, the diagnosis and prediction of metastasis, especially lymph node metastasis, is important when selecting the treatment option to be used for a particular NET.…”

Section: Introductionmentioning

confidence: 99%

Risk Factors Associated with the Development of Metastases in Patients with Gastroenteropancreatic Neuroendocrine Tumors

Kohno¹,

Ikegami²,

Ikegami³

et al. 2021

Preprint

View full text Add to dashboard Cite

Neuroendocrine tumors develop from systemic endocrine and nerve cells, and their occurrence has increased recently. Since these tumors are heterogeneous, pathological classification has been based on the affected organ. In 2019, the World Health Organization introduced a change that is expected to influence neuroendocrine tumor research, as gastroenteropancreatic neuroendocrine tumors are now included within a unified classification. In this retrospective study, we aimed to investigate the characteristics (e.g., lymph node metastases, all other metastases) of gastroenteropancreatic neuroendocrine tumors using this new classification in 50 cases. Tumor size, depth, MIB-1 index, lymphatic invasion, venous invasion, and neuroendocrine tumor grade were significantly correlated with lymph node metastasis and all other metastases. Venous invasion was more strongly correlated with lymph node metastasis and all other types of metastasis than with lymphatic invasion. Identification rates for lymphatic invasion were considered lower because of structural problems such as lymphatic vessels being much thinner than veins. However, venous invasion was considered effective in compensating for the low rate of identification in cases of lymphatic invasion. In future research, a unified classification and standardized framework for assessment will be important when analyzing the characteristics of neuroendocrine tumors, and large-scale studies are required.

show abstract

Surgical treatment for gastrointestinal neuroendocrine tumors

Cited by 22 publications

References 61 publications

Gastric neuroendocrine neoplasms and precursor lesions

Gastric neuroendocrine neoplasms and precursor lesions

Risk Factors Associated with the Development of Metastases in Patients with Gastroenteropancreatic Neuroendocrine Tumors

Contact Info

Product

Resources

About