Progression after endoscopic treatment for type I gastric neuroendocrine tumors: A single-center retrospective study.

BACKGROUND

Endoscopic treatment is the primary therapy for type I gastric neuroendocrine tumors (G-NETs), but it may not address the underlying pathogenesis, increasing the risk of progression.

AIM: To investigate the effectiveness of endoscopic treatment and identify progression risk factors.

METHODS

This retrospective study involved 128 patients with type I G-NETs treated between January 2009 and May 2024. The patients were categorized into non-progressive (n = 87) and progressive (n = 41) groups. Baseline characteristics, treatment details, and follow-up data were analyzed using univariate and multivariate Cox regression analyses to identify prognostic variables.

RESULTS

The baseline characteristics analysis showed no significant differences between the groups. The median follow-up time was 25.5 months (14.00-58.50 months). The univariate and multivariate analyses confirmed that endoscopic treatment combined with adjuvant somatostatin analogs (SSAs) was associated with a lower risk of progression (hazard ratio = 0.38, 95% confidence interval: 0.17-0.90, P = 0.027), whereas a neutrophil-to-lymphocyte ratio (NLR) of ≥ 2 indicated a higher risk (hazard ratio = 2.14, 95% confidence interval: 1.08-4.26, P = 0.030). Kaplan-Meier analysis confirmed NLR ≥ 2 and adjuvant SSA use as independent prognostic variables.

CONCLUSION

Combining endoscopic treatment with SSAs is effective for managing type I G-NETs. SSAs and NLR were identified as independent prognostic factors, highlighting their potential to reduce recurrence risk and improve outcomes.