Gianluca Esposito1, Maria Cazzato1, Maria Rinzivillo2, Emanuela Pilozzi3, Edith Lahner1, Bruno Annibale1, Francesco Panzuto4. 1. Digestive Disease Unit, Sant'Andrea University Hospital, Sapienza University of Rome, ENETS Center of Excellence, Rome, Italy; Department of Medical-Surgical Sciences and Translational Medicine, Sapienza University of Rome, Rome, Italy. 2. Digestive Disease Unit, Sant'Andrea University Hospital, Sapienza University of Rome, ENETS Center of Excellence, Rome, Italy. 3. Department of Clinical and Molecular Medicine, Sant'Andrea University Hospital, Sapienza University of Rome, ENETS Center of Excellence, Rome, Italy. 4. Digestive Disease Unit, Sant'Andrea University Hospital, Sapienza University of Rome, ENETS Center of Excellence, Rome, Italy. Electronic address: fpanzuto@ospedalesantandrea.it.
Abstract
BACKGROUND: This study aimed to evaluate the outcome of patients with type 1 gastric neuroendocrine neoplasia (T1gNENs) treated with different endoscopic approaches. METHODS: Patients were managed with endoscopic surveillance at regular intervals. Resection was performed by forceps or cold snare in tumours < 10 mm, otherwise mucosal resection (EMR) or submucosal dissection (ESD) were done. RESULTS: 127 T1gNENs, detected in 80 patients, were included. 87.4% of them were <5 mm, whereas 8.7% were 6-10 mm, 3.1% were 11-20 mm, and 0.8% was >20 mm. Ki67 <3%% was found in 85.8% tumours, whereas it was 3%-20% in the remaining 14.2% lesions. Noninterventional management (surveillance without radical resection) was performed in 15 patients (18.7%) with T1gNENs <5 mm. None of them underwent disease progression during follow-up. among the 65 patients treated by radical endoscopic resection, 37 patients (56.9%) had disease recurrence. 48.5% T1gNENs were removed by forceps, 16.8% by cold snare, 31.7% by EMR and 3% by ESD. The recurrence rate was similar among the different endoscopic techniques used. CONCLUSIONS: The management of T1gNENs may be planned based on tumour size. T1gNENs < 5 mm for which the initial removal is not radical could be followed up by noninterventional endoscopic surveillance.
BACKGROUND: This study aimed to evaluate the outcome of patients with type 1 gastric neuroendocrine neoplasia (T1gNENs) treated with different endoscopic approaches. METHODS: Patients were managed with endoscopic surveillance at regular intervals. Resection was performed by forceps or cold snare in tumours < 10 mm, otherwise mucosal resection (EMR) or submucosal dissection (ESD) were done. RESULTS: 127 T1gNENs, detected in 80 patients, were included. 87.4% of them were <5 mm, whereas 8.7% were 6-10 mm, 3.1% were 11-20 mm, and 0.8% was >20 mm. Ki67 <3%% was found in 85.8% tumours, whereas it was 3%-20% in the remaining 14.2% lesions. Noninterventional management (surveillance without radical resection) was performed in 15 patients (18.7%) with T1gNENs <5 mm. None of them underwent disease progression during follow-up. among the 65 patients treated by radical endoscopic resection, 37 patients (56.9%) had disease recurrence. 48.5% T1gNENs were removed by forceps, 16.8% by cold snare, 31.7% by EMR and 3% by ESD. The recurrence rate was similar among the different endoscopic techniques used. CONCLUSIONS: The management of T1gNENs may be planned based on tumour size. T1gNENs < 5 mm for which the initial removal is not radical could be followed up by noninterventional endoscopic surveillance.
Authors: Maria Rinzivillo; Francesco Panzuto; Gianluca Esposito; Edith Lahner; Alberto Signore; Bruno Annibale Journal: J Clin Med Date: 2022-03-16 Impact factor: 4.241