Ravizza Davide, Giunta Mariangela, Sala Isabella, Bagnardi Vincenzo, Tamayo Darina, de Roberto Giuseppe, Trovato Cristina, Bravi Ivana, Soru Pietro, Maregatti Margherita, Pisa Eleonora, Bertani Emilio, Bonomo Guido, Spada Francesca, Nicola Fazio
Division of Endoscopy, European Institute of Oncology, IRCCS, Milan, Italy.
Department of Statistics and Quantitative Methods, University of Milano-Bicocca, Milan, Italy.
J Neuroendocrinol. 2024 Dec;36(12):e13440. doi: 10.1111/jne.13440. Epub 2024 Aug 27.
Few studies have been published on the long-term outcomes of patients with gastric neuroendocrine tumors (gNETs). We analyzed their management over a two-decade period, focusing on endoscopic and clinical outcomes. Clinical, laboratory, endoscopic, surgical, and histopathological data from Types 1 and 3 gNETs histologically diagnosed between March 2000 and December 2021 at the European Institute of Oncology (IEO, Milan) were retrospectively collected. Sixty-nine patients were included (60 Type 1, 9 Type 3): 53 (77%) were treated endoscopically, 6 (9%) surgically, and 10 (14%) did not receive any treatment. Overall, 293 lesions were removed endoscopically: 74% by forceps, 20% by endoscopic mucosal resection (EMR), and 5% by endoscopic submucosal dissection (ESD). No differences were observed between EMR and ESD in terms of complete resection rate (p value = .50) and complications rate (p value = .084). The median follow-up period was 5.8 years (range: 0.3-20.5), during which no gNET-related deaths were observed. Metachronous gNETs developed in 60% of patients with Type 1 gNET. Six patients with lymph node metastases (LNM) were younger (p value = .006) and had larger lesions (p value <.001) than patients without LNM. Most Type 1 gNETs were successfully excised using forceps, with EMR and ESD being equally effective. The presence of incomplete resection was not associated with a worse prognosis, which remains excellent in this highly recurrent disease. Younger age and a size ≥10 mm were associated with an increased risk of LNM. CLINICAL TRIAL REGISTRATION: Project code UID 2854.
关于胃神经内分泌肿瘤（gNETs）患者的长期预后，发表的研究较少。我们分析了20年间对其的治疗情况，重点关注内镜和临床结果。回顾性收集了2000年3月至2021年12月在欧洲肿瘤研究所（米兰IEO）经组织学诊断为1型和3型gNETs患者的临床、实验室、内镜、手术及组织病理学数据。纳入69例患者（60例1型，9例3型）：53例（77%）接受内镜治疗，6例（9%）接受手术治疗，10例（14%）未接受任何治疗。总体而言，通过内镜切除了293个病灶：74%通过活检钳切除，20%通过内镜黏膜切除术（EMR），5%通过内镜黏膜下剥离术（ESD）。在完全切除率（p值 = 0.50）和并发症发生率（p值 = 0.084）方面，EMR和ESD之间未观察到差异。中位随访期为5.8年（范围：0.3 - 20.5年），在此期间未观察到与gNET相关的死亡。60%的1型gNET患者出现异时性gNET。6例有淋巴结转移（LNM）的患者比无LNM的患者更年轻（p值 = 0.006）且病灶更大（p值 < 0.001）。大多数1型gNETs使用活检钳成功切除，EMR和ESD效果相当。不完全切除与预后较差无关，在这种高复发性疾病中预后仍然良好。年龄较小和大小≥10 mm与LNM风险增加相关。临床试验注册号：项目代码UID 2854。
