Clinical features and outcomes of gastric neuroendocrine tumors after endoscopic diagnosis and treatment a digestive endoscopy society of tawian (dest)

Chen Shuan Chung, Cho Lun Tsai, Yin Yi Chu, Kuan Chih Chen, Jung Chun Lin, Bao Chung Chen, Wei Chih Sun, Hsu Heng Yen, Chiung Yu Chen, I. Chen Wu, Chao Hung Kuo, Hisang Yao Shih, Ming Jong Bair, Jack P. Wang, Wen Hao Hu, Chang Shyue Yang, Ming Lun Han, Tsu Yao Cheng, Chao Ming Tseng, Ming Chang TsaiMing Luen Hu, Hsiu Po Wang

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4 Citations (Scopus)

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.

Original languageEnglish
Article numbere12101
JournalMedicine (United States)
Volume97
Issue number38
DOIs
Publication statusPublished - 2018 Sep 1

All Science Journal Classification (ASJC) codes

  • Medicine(all)

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