Journal of digestive diseases · 2015
Long-term outcome of endoscopic and surgical resection for foregut neuroendocrine tumors.
Сравнительное исследованиеСтатьяПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Jung Hee Jae, Hong Su Jin, Han Jae Pil, Kim Hyun Su, Jeong Gui-Ae, Cho Gyu-Seok, Kim Hee Kyoung, Ko Bong Min, Lee Moon Sung
Аннотация
OBJECTIVE: Endoscopic resection (ER) of foregut neuroendocrine tumors (NETs) is increasingly performed instead of surgery. This study aimed to compare the long-term therapeutic outcomes of ER and surgical resection (SR) for foregut NETs.
METHODS: From 2002 to 2012, a total of 49 patients with histologically confirmed foregut NETs were treated by ER (n = 33) and SR (n = 16). The clinicopathological characteristics and therapeutic outcomes were evaluated.
RESULTS: Of the 33 patients who underwent ER [endoscopic mucosal resection (n = 26), endoscopic mucosal dissection (n = 7)], 32 were diagnosed as NET-G1 and NET-G2, and the other as neuroendocrine carcinoma (NEC). Of the 16 patients who underwent SR, 10 were diagnosed as NET-G1, 2 as NET-G2 and 4 as NEC. The median tumor size was significantly smaller in the ER group compared with the SR group (7 mm vs 19 mm, P = 0.001). In almost all patients treated with ER (32/33), NET invasion was limited to the mucosa and submucosa. Non-curative resections were observed in 24.2% of the patients in the ER group (8/33) and 25.0% in the SR group (4/16). No recurrence occurred in NET cases with positive resection margins by ER. However, all cases of non-curative resection with lymphatic invasion (one in the ER group and four in the SR group) developed liver metastasis during the follow-up despite complete resection, and all these five patients has histologically confirmed NECs.
CONCLUSION: NET patients treated by ER may have a good prognosis if the tumor size is small and histologically low grade without lymphatic invasion.
METHODS: From 2002 to 2012, a total of 49 patients with histologically confirmed foregut NETs were treated by ER (n = 33) and SR (n = 16). The clinicopathological characteristics and therapeutic outcomes were evaluated.
RESULTS: Of the 33 patients who underwent ER [endoscopic mucosal resection (n = 26), endoscopic mucosal dissection (n = 7)], 32 were diagnosed as NET-G1 and NET-G2, and the other as neuroendocrine carcinoma (NEC). Of the 16 patients who underwent SR, 10 were diagnosed as NET-G1, 2 as NET-G2 and 4 as NEC. The median tumor size was significantly smaller in the ER group compared with the SR group (7 mm vs 19 mm, P = 0.001). In almost all patients treated with ER (32/33), NET invasion was limited to the mucosa and submucosa. Non-curative resections were observed in 24.2% of the patients in the ER group (8/33) and 25.0% in the SR group (4/16). No recurrence occurred in NET cases with positive resection margins by ER. However, all cases of non-curative resection with lymphatic invasion (one in the ER group and four in the SR group) developed liver metastasis during the follow-up despite complete resection, and all these five patients has histologically confirmed NECs.
CONCLUSION: NET patients treated by ER may have a good prognosis if the tumor size is small and histologically low grade without lymphatic invasion.