Clinical features and outcomes of gastric neuroendocrine tumors after endoscopic diagnosis and treatment a digestive endoscopy society of tawian (dest)
Journal
Medicine (United States)
Journal Volume
97
Journal Issue
38
Date Issued
2018
Author(s)
Chung C.-S.
Tsai C.-L.
Chu Y.-Y.
Chen K.-C.
Lin J.-C.
Chen B.-C.
Sun W.-C.
Yen H.-H.
Chen C.-Y.
Wu I.-C.
Kuo C.-H.
Shih H.-Y.
Bair M.-J.
Wang J.P.
Yang C.-S.
Tseng C.-M.
Tsai M.-C.
Hu M.-L.
Abstract
Gastric neuroendocrine tumors (GNETs) are a heterogeneous group of neoplasm with varying biological characteristics. This study aimed to investigate the clinical features and outcomes of GNET patients after endoscopic diagnosis and treatment in a multicenter registry. Patients with GNETs confirmed histologically were recruited from 17 hospitals between January 2010 and April 2016 in Taiwan. Clinical, laboratory, radiological, endoscopic, pathological data, treatment strategies, follow-up periods, and survivals were collected retrospectively. Totally 187 (107 female, 80 male) patients were recruited. Mean (±standard deviation [SD]) age and size of tumors were 63.2-year-old (±14.6) and 2.3-cm (±3.0). World Health Organization (WHO) grading were 93 (49.7%) G1, 26 (13.9%) G2, 40 (21.4%) G3, and 28 (15.0%) unknown. G3 patients were older (mean±SD, 71.6±12.4 vs. 60.9±14.3/56.7±15.4 years), larger (6.1±4.0 vs.1.2±1.3/2.4±2.5 cm), more distally located (35.0% vs. 7.6%/15.4%), lower proportion of superficial lesions (17.5% vs. 61.9%/53.8%) and higher rates of lymphovascular invasion (32.5% vs. 3.2%/7.7%) than G1/G2. There was no nodal or distant organ metastases despite different grading of lesions≦10mm and those <20mm limited to mucosa and submucosa layers. GNETs larger than 20mm with G1, G2, and G3 had lymph node (LN) metastatic rates of 21.4%, 30.0%, and 59.3%, respectively. Survivals were different between grading for those >20mm(log-rank test P=.02). Male gender (P=.01), deeper invasion (P=.0001), nodal (P<.0001), and distant organ metastases (P=.0001) were associated with worse outcome. In conclusion, treatment strategies for GNET should be decided by grading, size, invasiveness, and LN metastasis risk. Curative endoscopic resection is feasible for G1/2 lesions less than 20mm and limited to mucosa/submucosa layers without lymphovascular invasion. ? 2018 the Author(s). Published by Wolters Kluwer Health, Inc.
SDGs
Other Subjects
adult; Article; cancer grading; cancer survival; clinical feature; digestive tract endoscopy; distant metastasis; endoscopic surgery; female; gender; human; log rank test; lymph vessel metastasis; major clinical study; male; middle aged; neuroendocrine tumor; priority journal; stomach; Taiwan; age distribution; aged; clinical trial; epidemiology; gastrointestinal endoscopy; Kaplan Meier method; lymph node metastasis; multicenter study; neuroendocrine tumor; pathology; procedures; prognosis; retrospective study; socioeconomics; stomach mucosa; stomach tumor; tumor invasion; very elderly; young adult; tumor marker; Adult; Age Distribution; Aged; Aged, 80 and over; Biomarkers, Tumor; Endoscopy, Gastrointestinal; Female; Gastric Mucosa; Humans; Kaplan-Meier Estimate; Lymphatic Metastasis; Male; Middle Aged; Neoplasm Grading; Neoplasm Invasiveness; Neuroendocrine Tumors; Prognosis; Retrospective Studies; Socioeconomic Factors; Stomach Neoplasms; Taiwan; Young Adult
Publisher
Lippincott Williams and Wilkins
Type
journal article