Tumour type and size are prognostic factors in gastric neuroendocrine neoplasia: A multicentre retrospective study

Panzuto, Francesco; Campana, Davide; Massironi, Sara; Faggiano, Antongiulio; Rinzivillo, Maria; Sciola, V.; Lahner, Edith; Manuzzi, Lisa; Colao, Annamaria; Annibale, Bruno

doi:10.1016/j.dld.2019.04.016

Cited by 40 publications

(34 citation statements)

References 24 publications

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“…For early gastrointestinal neuroendocrine neoplasms, main research should focus on the detection of small tumors and the histopathological changes in the mucosa and submucosa caused by tumor invasion. Tumor size was reported to be one of the most relevant factors affecting patient management [33,34]. However, small neuroendocrine tumors are hard to spot since they rarely cause specific symptoms.…”

Section: Discussionmentioning

confidence: 99%

Label-Free Identification of Early Gastrointestinal Neuroendocrine Tumors via Biomedical Multiphoton Microscopy and Automatic Image Analysis

Huang

Qiu

et al. 2020

IEEE Access

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At present, early diagnosis and treatment is the most effective way to treat early gastrointestinal neuroendocrine tumors. Therefore, we attempted to carry out multiphoton imaging of early neuroendocrine tumors because of its ability to label-free image tissue microstructure at the cellular level. Imaging results show that this imaging technique can quickly identify the histopathological changes in mucosa and submucosa caused by tumor invasion. Furthermore, we performed automatic image analysis on SHG images and extracted two optical diagnostic features-collagen density and average intensity, and also found obvious differences in the density as well as average intensity of collagen fibers in tumor microenvironment using a series of quantitative analysis. These findings may further facilitate the development of multiphoton microscopic imaging technique for clinical use. INDEX TERMS Multiphoton imaging, image analysis, gastrointestinal neuroendocrine tumors.

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Section: Discussionmentioning

confidence: 99%

Label-Free Identification of Early Gastrointestinal Neuroendocrine Tumors via Biomedical Multiphoton Microscopy and Automatic Image Analysis

Huang

Qiu

et al. 2020

IEEE Access

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“…Recurrence after presumed successful treatment is common because hypergastrinemia and underlying Enterochromaffin-like (ECL) cells hyperplastic or dysplastic changes persist, as high as 65% within a year after initial endoscopic treatment. 19,22 Additionally, the recurrence rate is likely to be affected by the type of endoscopic procedure used to remove the neoplastic lesions, 14,48 as confirmed by the lower recurrence rates reported by Japanese studies, where the use of ESD is more common compared to standard polypectomy. 21 The surgical approach, either antrectomy to achieve gastrin suppression or partial/total gastrectomy, was more common in the past and probably represented an over-treatment for this subset of relatively indolent tumors, also considering both the risk of surgery as well as the potential risk of developing adenocarcinoma in the remaining mucosa.…”

Section: Discussionmentioning

confidence: 96%

“…3 In a recent multicenter Italian study, including 156 gNETs, a tumor size >10 mm was significantly associated with potentially malignant tumor behavior, irrespective of Ki67. 19 The clinical management and treatment of gNET-1s are a matter of debate as they are relatively benign lesions, 9,12,20 therefore minimally invasive procedures are warranted. Small (1 cm) localized tumors should be endoscopically resected.…”

Section: Introductionmentioning

confidence: 99%

“…Long-acting somatostatin analogs (SSAs) can be used to both inhibit gastrin release and directly inhibit endocrine cell proliferation. 6,9,19,[33][34][35][36][37][38][39][40] SSA therapy can reduce and even normalize the gastrin and chromogranin A (CgA) levels as well as induce regression of gNET-1, 19,41,42 thus represent a valid therapeutic option. A high recurrence rate after the end of treatment has been reported, 20 which makes the efficacy of this treatment questionable.…”

Section: Introductionmentioning

confidence: 99%

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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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“…Beyond the tumour type, size is well recognized as one of the main prognostic factors in gNENs, affecting patient management and driving the best therapeutic choice [12]. European guidelines [11] recommend endoscopic submucosal dissection (ESD) as the treatment of choice for gastric superficial neoplastic lesions with a low risk of lymph node metastasis, and it is considered the best technique to achieve complete en bloc resection for early gastric cancer even for Japanese guidelines [13].…”

Section: Introductionmentioning

confidence: 99%

Comparison of Endoscopic Techniques in the Management of Type I Gastric Neuroendocrine Neoplasia: A Systematic Review

Panzuto

Esposito

Rinzivillo

et al. 2021

Gastroenterology Research and Practice

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Background. Endoscopic resection is considered the treatment of choice for type I gastric neuroendocrine neoplasia (gNEN) given its indolent behaviour; however, the favoured endoscopic technique to remove these tumours is not well established. Aims. This systematic review is aimed at investigating the best endoscopic management for type I gNEN. Methods. PubMed Central/Medline and Scopus were systematically searched for records up to August 31, 2020. Results. After screening the 675 retrieved records, 6 studies were selected for the final analysis. The main endoscopic resection techniques described were endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD). Overall, 112 gNENs were removed by EMR and 77 by ESD. Both techniques showed similar results for complete and en bloc resection (97.4% and 98.7%; 92.3% and 96.3% with ESD and EMR, respectively). ESD was associated with a higher rate of complications than EMR (11.7% vs. 5.4%), but this difference was not statistically significant ( p = 0.17 ). The rates of recurrence during follow-up were 18.2% and 11.5% for EMR and ESD, respectively. Conclusions. To date, there are no sufficient data showing superiority of a given endoscopic technique over others. Both ESD and EMR seem to be effective in the management of type I gNEN, with a relatively low rate of recurrence.

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Tumour type and size are prognostic factors in gastric neuroendocrine neoplasia: A multicentre retrospective study

Cited by 40 publications

References 24 publications

Label-Free Identification of Early Gastrointestinal Neuroendocrine Tumors via Biomedical Multiphoton Microscopy and Automatic Image Analysis

Label-Free Identification of Early Gastrointestinal Neuroendocrine Tumors via Biomedical Multiphoton Microscopy and Automatic Image Analysis

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

Comparison of Endoscopic Techniques in the Management of Type I Gastric Neuroendocrine Neoplasia: A Systematic Review

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