Efficacy and safety of endoscopic submucosal dissection for gastrointestinal neuroendocrine tumors: a 10-year data analysis of Northern China. (4th March 2019)

• Record Type: Journal Article
• Authors: Chen, Xin; Li, Bianxia; Wang, Saiyu; Yang, Bo; Zhu, Lanping; Ma, Shuang; Wu, Jingyi; He, Qijin; Zhao, Jingwen; Zheng, Zhongqing; Li, Shu; Wang, Tao; Liang, Li
• Is Part Of: Scandinavian journal of gastroenterology. Volume 54:Number 3(2019)
• Page Start: 384
• Page End: 389
• Publication Date: 2019-03-04
• Subjects: Gastrointestinal neuroendocrine tumors -- endoscopic submucosal dissection -- indication -- gastrointestinal volume -- therapy; Gastroenterology -- Periodicals; Digestive organs -- Diseases -- Periodicals; 616.33
• DOI: 10.1080/00365521.2019.1588367
• Languages: English
• ISSNs: 0036-5521

Abstract

Abstract: Objective: Endoscopy is the main method to treat gastrointestinal neuroendocrine tumors (GI-NETs), but the specific indications are still controversial. We aim to investigate the clinical outcomes of GI-NETs patients who experienced endoscopic submucosal dissection (ESD). Methods: We retrospectively reviewed the clinical features and prognosis of 65 GI-NETs patients who underwent ESD between 2008 and 2018. Results: A total of 65 patients diagnosed with GI-NETs pathologically, bearing 75 lesions, were found by endoscopy incidentally for other symptoms. The locations of these lesions were stomach ( n = 24), duodenal bulb ( n = 4) and rectum ( n = 47). The diameter of 75 tumors were as follows: size ≤ 1 cm (78.7%), 1 cm < size ≤ 2 cm (17.3%), 2 cm < size ≤ 3.5 cm (4.0%). Endoscopic ultrasonography (EUS) suggested that 72 lesions were confined to submucosa and 3 lesions invaded into muscularis propria. The rates of en bloc resection and complete resection were all 100% and the rates of intraoperative bleeding and perforation were 2.7% and 1.3%, respectively. None of the 65 patients had lymph nodes and distant metastasis during the period of study. Conclusion: For GI-NETs without lymph nodes and distant metastases, the lesion confined to submucosa with the diameter ≤1 cm is absolute indication of ESD. For rectal neuroendocrine tumors limited in submucosa with the diameter between 1 and 2 cm, and Type 1 gastric neuroendocrine tumors predicted to be T2, ESD should be prioritized to preserve gastrointestinal volume and function at initial treatment.