Management of Duodenal Neuroendocrine Tumors: Surgical versus Endoscopic Mucosal Resection

Catherine G Tran; Scott K Sherman; Mohammed O Suraju; Apoorve Nayyar; Henning Gerke; Rami G. El Abiad; Chandrikha Chandrasekharan; Po Hien Ear; Thomas M O’Dorisio; Joseph S Dillon; Andrew M Bellizzi; James R Howe

doi:10.1245/s10434-021-10774-9

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Management of Duodenal Neuroendocrine Tumors: Surgical versus Endoscopic Mucosal Resection

Journal article

Peer reviewed

Management of Duodenal Neuroendocrine Tumors: Surgical versus Endoscopic Mucosal Resection

Catherine G Tran, Scott K Sherman, Mohammed O Suraju, Apoorve Nayyar, Henning Gerke, Rami G. El Abiad, Chandrikha Chandrasekharan, Po Hien Ear, Thomas M O’Dorisio, Joseph S Dillon, …

Annals of surgical oncology, Vol.29, pp.75-84

09/13/2021

DOI: 10.1245/s10434-021-10774-9

PMCID: PMC8688294

PMID: 34515889

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https://www.ncbi.nlm.nih.gov/pmc/articles/8688294View

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Abstract

Background: Management of duodenal neuroendocrine tumors (DNETs) is not standardized, with smaller lesions (< 1-2 cm) generally treated by endoscopic mucosal resection (EMR) and larger DNETs by surgical resection (SR). This study reviewed how patients were selected for treatment and compared outcomes. Patients and methods: Patients with DNETs undergoing resection were identified through institutional databases, and clinicopathologic data recorded. χ2 and Wilcoxon tests compared variables. Survival was determined by Kaplan-Meier, and Cox regression tested association with survival. Results: Among 104 patients, 64 underwent EMR and 40 had SR. Patients selected for SR had larger tumor size, younger age, and higher T, N, and M stage. There was no difference in progression-free (PFS) or overall survival (OS) between SR and EMR. In 1-2 cm DNETs, there was no difference in PFS between SR and EMR [median not reached (NR), P = 0.1]; however, longer OS was seen in SR (median NR versus 112 months, P = 0.03). In 1-2 cm DNETs, SR patients were more likely to be node-positive and younger. After adjustment for age, resection method did not correlate with survival. Comparison of surgically resected DNETs versus jejunoileal NETs revealed longer PFS (median NR versus 73 months, P < 0.001) and OS (median NR versus 119 months, P = 0.004) DISCUSSION: In 1-2 cm DNETs, there was no difference in survival between EMR and SR after adjustment for age. Recurrences could be salvaged, suggesting that EMR is a reasonable strategy. Compared with jejunoileal NETs, DNETs treated by SR had improved PFS and OS. Keywords: Duodenal neuroendocrine tumors; Duodenum; Endoscopic mucosal resection; Endoscopy; Neuroendocrine; Surgery. © 2021. Society of Surgical Oncology.

Details

Title: Subtitle: Management of Duodenal Neuroendocrine Tumors: Surgical versus Endoscopic Mucosal Resection
Creators: Catherine G Tran - University of Iowa
Scott K Sherman - University of Iowa, Surgery
Mohammed O Suraju - University of Iowa Hospitals and Clinics
Apoorve Nayyar
Henning Gerke - University of Iowa, Internal Medicine
Rami G. El Abiad - University of Iowa, Internal Medicine
Chandrikha Chandrasekharan - University of Iowa, Internal Medicine
Po Hien Ear - University of Iowa, Surgery
Thomas M O’Dorisio - University of Iowa, Internal Medicine
Joseph S Dillon - University of Iowa, Endocrinology and Metabolism
Andrew M Bellizzi - University of Iowa, Pathology
James R Howe - University of Iowa, Surgery
Resource Type: Journal article
Publication Details: Annals of surgical oncology, Vol.29, pp.75-84
DOI: 10.1245/s10434-021-10774-9
PMID: 34515889
PMCID: PMC8688294
NLM abbreviation: Ann Surg Oncol
ISSN: 1068-9265
eISSN: 1534-4681
Grant note: DOI: 10.13039/100000054, name: National Cancer Institute, award: P50CA174521, T32CA078586, T32CA148062
Language: English
Date published: 09/13/2021
Academic Unit: Hematology, Oncology, and Blood & Marrow Transplantation; Gastroenterology and Hepatology; Pathology; Surgery; Fraternal Order of Eagles Diabetes Research Center; Endocrinology and Metabolism; Internal Medicine
Record Identifier: 9984183985102771

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