Exarchou, Klaire, Hu, Haiyi, Stephens, Nathan A, Moore, Andrew R, Kelly, Mark, Lamarca, Angela, Mansoor, Wasat, Hubner, Richard, McNamara, Mairead G, Smart, Howard et al (show 3 more authors)
(2022)
Endoscopic surveillance alone is feasible and safe in type I gastric neuroendocrine neoplasms less than 10 mm in diameter.
ENDOCRINE, 78 (1).
pp. 186-196.
Abstract
<h4>Purpose</h4>Type I gastric neuroendocrine neoplasms (g-NENs) have a low risk of metastasis and a generally favourable prognosis. Patients with small type I g-NENs (≤10 mm) frequently require no treatment, whereas those with larger polyps usually undergo resection. We evaluated the safety and outcomes of endoscopic surveillance after no initial treatment in selected patients with type I g-NENs.<h4>Methods</h4>Retrospective analysis of type I g-NEN patients across two European Neuroendocrine Tumour Society Centers of Excellence 2003-2019.<h4>Results</h4>Following initial assessment, 87 of 115 patients with type I g-NEN (75 with polyps ≤10 mm) received no initial treatment and underwent endoscopic surveillance. 79/87 (91%) demonstrated no clinically meaningful change in tumour size or grade over a median 62 month follow up. Only two patients developed NEN progression that required a change in management and two other patients developed gastric adenocarcinoma/high grade dysplasia; all four initially had ≥11 mm g-NENs.<h4>Conclusions</h4>Patients with ≤10 mm type I g-NENs were unlikely to develop clinically significant tumour progression and in most cases, resection was not needed. The endoscopic surveillance interval could therefore potentially be safely increased to every 2-3 years in such patients. However, lifelong surveillance is still advocated due to the additional risk of developing gastric adenocarcinoma.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | Neuroendocrine tumour, Carcinoid, Stomach, Surveillance, Endoscopy, Surgery |
| Divisions: | Faculty of Health and Life Sciences Faculty of Health and Life Sciences > Institute of Systems, Molecular and Integrative Biology |
| Depositing User: | Symplectic Admin |
| Date Deposited: | 09 Aug 2022 08:39 |
| Last Modified: | 18 Jan 2023 20:53 |
| DOI: | 10.1007/s12020-022-03143-3 |
| Open Access URL: | https://doi.org/10.1007/s12020-022-03143-3 |
| Related URLs: | |
| URI: | https://livrepository.liverpool.ac.uk/id/eprint/3160780 |
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