Klaire Exarchou1,2, Nathan Howes2, David Mark Pritchard1,2. 1. Department of Cellular and Molecular Physiology, Institute of Translational Medicine, University of Liverpool, Liverpool, UK. 2. Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK.
Abstract
BACKGROUND: Neuroendocrine tumours (NETs) of the stomach and duodenum are rare, but are increasing in incidence. Optimal management of localised, low-grade gastric and duodenal NETs remains controversial. AIMS: To systematically review recent literature that has evaluated the management of localised low-grade gastric and duodenal NETs. METHODS: A systematic literature search was conducted. Articles were screened and eligible articles fully assessed. Additional articles were identified through the included articles' reference lists. RESULTS: Several relevant retrospective case series were identified, but there was considerable heterogeneity between studies and they reported a variety of parameters. Type I gastric NETs had an excellent prognosis and conservative management approaches such as endoscopic surveillance/resection were appropriate in most cases. Many type III gastric NETs were low grade and appeared to have a better prognosis than has previously been appreciated. Endoscopic rather than surgical resection was therefore effective in some patients who had small, low-grade tumours. Duodenal NETs were more heterogenous. Endoscopic resection was generally safe and effective in patients who had small, low-grade, nonfunctional, non-ampullary tumours. However, some patients, especially those with larger or ampullary duodenal NETs, required surgical resection. CONCLUSIONS: Most type I gastric NETs behave indolently and surgical resection is only rarely indicated. Some type III gastric and duodenal NETs have a worse prognosis, but selected patients who have small, localised, nonfunctional, low-grade tumours are adequately and safely treated by endoscopic resection. Due to the complexity of this area, a multidisciplinary approach to management is strongly recommended.
BACKGROUND:Neuroendocrine tumours (NETs) of the stomach and duodenum are rare, but are increasing in incidence. Optimal management of localised, low-grade gastric and duodenal NETs remains controversial. AIMS: To systematically review recent literature that has evaluated the management of localised low-grade gastric and duodenal NETs. METHODS: A systematic literature search was conducted. Articles were screened and eligible articles fully assessed. Additional articles were identified through the included articles' reference lists. RESULTS: Several relevant retrospective case series were identified, but there was considerable heterogeneity between studies and they reported a variety of parameters. Type I gastric NETs had an excellent prognosis and conservative management approaches such as endoscopic surveillance/resection were appropriate in most cases. Many type III gastric NETs were low grade and appeared to have a better prognosis than has previously been appreciated. Endoscopic rather than surgical resection was therefore effective in some patients who had small, low-grade tumours. Duodenal NETs were more heterogenous. Endoscopic resection was generally safe and effective in patients who had small, low-grade, nonfunctional, non-ampullary tumours. However, some patients, especially those with larger or ampullary duodenal NETs, required surgical resection. CONCLUSIONS: Most type I gastric NETs behave indolently and surgical resection is only rarely indicated. Some type III gastric and duodenal NETs have a worse prognosis, but selected patients who have small, localised, nonfunctional, low-grade tumours are adequately and safely treated by endoscopic resection. Due to the complexity of this area, a multidisciplinary approach to management is strongly recommended.
Authors: Molly E Roseland; Isaac R Francis; Kimberly L Shampain; Erica B Stein; Ashish P Wasnik; John D Millet Journal: Abdom Radiol (NY) Date: 2022-04-12
Authors: Elettra Merola; Andrea Michielan; Umberto Rozzanigo; Marco Erini; Sandro Sferrazza; Stefano Marcucci; Chiara Sartori; Chiara Trentin; Giovanni de Pretis; Franca Chierichetti Journal: World J Gastrointest Surg Date: 2022-02-27
Authors: Klaire Exarchou; Haiyi Hu; Nathan A Stephens; Andrew R Moore; Mark Kelly; Angela Lamarca; Wasat Mansoor; Richard Hubner; Mairéad G McNamara; Howard Smart; Nathan R Howes; Juan W Valle; D Mark Pritchard Journal: Endocrine Date: 2022-07-27 Impact factor: 3.925
Authors: Klaire Exarchou; Nathan A Stephens; Andrew R Moore; Nathan R Howes; D Mark Pritchard Journal: Curr Oncol Rep Date: 2022-01-20 Impact factor: 5.075