BACKGROUND/AIMS: Limited data exist regarding the natural history of duodenal carcinoid tumors and the efficacy of endoscopic treatment. METHODS: A total of 27 patients with duodenal carcinoid tumors were enrolled. All tumors were located outside the periampullary region and were ≤10 mm in size. 11 patients underwent endoscopic mucosal resection (EMR) and argon plasma coagulation (APC). 13 patients did not undergo any specific procedure for tumor removal and were followed clinically. RESULTS: Of 13 patients not undergoing treatment, tumors disappeared in 5 cases during follow-up with diagnostic forceps biopsy. Endoscopically visible lesions remained in the last follow-up endoscopy in 8 patients (61.5%). No lymph node or distant metastases or tumor-related deaths occurred during a median follow-up of 37 months. Of 11 cases treated with EMR, tumor-free resection margins were achieved in 10 cases and no local recurrence occurred after treatment. Two perforations occurred during EMR. Of the 3 cases treated with APC, local recurrence occurred in 1 case. CONCLUSIONS: Given the risks associated with EMR and the likely favorable natural history of small duodenal carcinoid tumors, conservative management with close follow-up may represent a viable alternative to endoscopic treatment, especially in patients with a high risk of perioperative complications.
BACKGROUND/AIMS: Limited data exist regarding the natural history of duodenal carcinoid tumors and the efficacy of endoscopic treatment. METHODS: A total of 27 patients with duodenal carcinoid tumors were enrolled. All tumors were located outside the periampullary region and were ≤10 mm in size. 11 patients underwent endoscopic mucosal resection (EMR) and argon plasma coagulation (APC). 13 patients did not undergo any specific procedure for tumor removal and were followed clinically. RESULTS: Of 13 patients not undergoing treatment, tumors disappeared in 5 cases during follow-up with diagnostic forceps biopsy. Endoscopically visible lesions remained in the last follow-up endoscopy in 8 patients (61.5%). No lymph node or distant metastases or tumor-related deaths occurred during a median follow-up of 37 months. Of 11 cases treated with EMR, tumor-free resection margins were achieved in 10 cases and no local recurrence occurred after treatment. Two perforations occurred during EMR. Of the 3 cases treated with APC, local recurrence occurred in 1 case. CONCLUSIONS: Given the risks associated with EMR and the likely favorable natural history of small duodenal carcinoid tumors, conservative management with close follow-up may represent a viable alternative to endoscopic treatment, especially in patients with a high risk of perioperative complications.
Authors: Raf Bisschops; Miguel Areia; Emmanuel Coron; Daniela Dobru; Bernd Kaskas; Roman Kuvaev; Oliver Pech; Krish Ragunath; Bas Weusten; Pietro Familiari; Dirk Domagk; Roland Valori; Michal F Kaminski; Cristiano Spada; Michael Bretthauer; Cathy Bennett; Carlo Senore; Mário Dinis-Ribeiro; Matthew D Rutter Journal: United European Gastroenterol J Date: 2016-08-21 Impact factor: 4.623
Authors: Timothy Weatherall; Jason Denbo; John Sharpe; Michael Martin; Thomas O'Brien; Rajib Gupta; Kenneth Groshart; Stephen Behrman; Paxton Dickson Journal: World J Surg Date: 2017-03 Impact factor: 3.352
Authors: Bobby V M Dasari; Sarah Al-Shakhshir; Timothy M Pawlik; Tahir Shah; Ravi Marudanayagam; Robert P Sutcliffe; Darius F Mirza; Paolo Muiesan; Keith J Roberts; John Isaac Journal: J Gastrointest Surg Date: 2018-06-04 Impact factor: 3.452
Authors: Seung Woo Lee; Jae Kyu Sung; Young Sin Cho; Ki Bae Bang; Sun Hyung Kang; Ki Bae Kim; Sae Hee Kim; Hee Seok Moon; Kyung Ho Song; Sun Moon Kim; Il-Kwun Chung; Dong Soo Lee; Hyun Yong Jeong; Sei Jin Youn Journal: Medicine (Baltimore) Date: 2019-06 Impact factor: 1.817