학술논문
The Risk Factors for Metastasis in Non-Ampullary Duodenal Neuroendocrine Tumors Measuring 20 mm or Less in Diameter.
Document Type
Article
Author
Hatta, Waku; Koike, Tomoyuki; Iijima, Katsunori; asanuma, Kiyotaka; asano, Naoki; Musha, Hiroaki; Inomata, Yoshifumi; Sano, Toshikazu; Endo, Hiroyuki; Ikehata, atsushi; Horii, Toru; Ohyauchi, Motoki; Yokosawa, Satoshi; Kasajima, atsuko; Fujishima, Fumiyoshi; Sasano, Hironobu; Nakaya, Naoki; Nakamura, Tomohiro; Shimosegawa, Tooru
Source
Subject
*NEUROENDOCRINE tumors
*DUODENAL diseases
*TUMOR growth
*THERAPEUTICS
RISK of metastasis
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Language
ISSN
0012-2823
Abstract
Background/Aims: The treatment strategy for non-ampullary duodenal neuroendocrine tumors (NAD-NETs) ⩽ 20 mm in diameter has not been established. In this study, we aimed to evaluate the detailed characteristics of NAD-NETs ⩽ 20 mm in diameter to clarify the risk factors of subsequent metastasis. Methods: The patients with NAD-NETs ⩽ 20 mm in diameter who had been treated at 12 institutions between 1992 and 2013 were enrolled. Clinical records were retrieved, and histopathological findings of all cases were centrally reviewed by 2 pathologists. Results: We studied 49 patients with a mean follow-up period of 66.5 months. Thirty-five patients were initially treated with endoscopic resection (ER), and 14 with surgery. A univariate analysis revealed the ORs and 95% CIs of the risk factors for metastasis were lymphovascular invasion (12.5 [2.01-77.9]), multiple tumors (9.75 [1.46-65.4]), a tumor size of 11-20 mm (6.67 [1.21-36.6]), and World Health Organization grade G2 (7.13 [1.16-43.9]). Five-year overall and disease-specific survival rates were 86.1 and 97.2%, respectively. Conclusion: This is the first study to demonstrate the risk factors of metastasis in NAD-NETs ⩽ 20 mm in diameter. These findings may be helpful for determining the appropriate therapeutic approach and the clinical strategy of treatment following ER. [ABSTRACT FROM AUTHOR]