Exarchou, Klaire, Howes, Nathan and Pritchard, David Mark 
ORCID: 0000-0001-7971-3561
(2020)
Systematic review: management of localised low-grade upper gastrointestinal neuroendocrine tumours.
ALIMENTARY PHARMACOLOGY & THERAPEUTICS, 51 (12).
pp. 1247-1267.
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Exarchou et al APT review accepted version.pdf - Author Accepted Manuscript Download (1MB) | Preview |
Abstract
<h4>Background</h4>Neuroendocrine tumours (NETs) of the stomach and duodenum are rare, but are increasing in incidence. Optimal management of localised, low-grade gastric and duodenal NETs remains controversial.<h4>Aims</h4>To systematically review recent literature that has evaluated the management of localised low-grade gastric and duodenal NETs.<h4>Methods</h4>A systematic literature search was conducted. Articles were screened and eligible articles fully assessed. Additional articles were identified through the included articles' reference lists.<h4>Results</h4>Several relevant retrospective case series were identified, but there was considerable heterogeneity between studies and they reported a variety of parameters. Type I gastric NETs had an excellent prognosis and conservative management approaches such as endoscopic surveillance/resection were appropriate in most cases. Many type III gastric NETs were low grade and appeared to have a better prognosis than has previously been appreciated. Endoscopic rather than surgical resection was therefore effective in some patients who had small, low-grade tumours. Duodenal NETs were more heterogenous. Endoscopic resection was generally safe and effective in patients who had small, low-grade, nonfunctional, non-ampullary tumours. However, some patients, especially those with larger or ampullary duodenal NETs, required surgical resection.<h4>Conclusions</h4>Most type I gastric NETs behave indolently and surgical resection is only rarely indicated. Some type III gastric and duodenal NETs have a worse prognosis, but selected patients who have small, localised, nonfunctional, low-grade tumours are adequately and safely treated by endoscopic resection. Due to the complexity of this area, a multidisciplinary approach to management is strongly recommended.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | Upper Gastrointestinal Tract, Humans, Neuroendocrine Tumors, Gastrointestinal Neoplasms, Endoscopy, Gastrointestinal, Prognosis, Retrospective Studies, Neoplasm Grading |
| Depositing User: | Symplectic Admin |
| Date Deposited: | 22 May 2020 10:48 |
| Last Modified: | 08 Feb 2024 14:02 |
| DOI: | 10.1111/apt.15765 |
| Related URLs: | |
| URI: | https://livrepository.liverpool.ac.uk/id/eprint/3088426 |
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