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CC BY-NC-ND 4.0 · Endosc Int Open 2023; 11(11): E1099-E1107
DOI: 10.1055/a-2181-0320
Original article

Duodenal neuroendocrine tumors: Short-term outcomes of endoscopic submucosal dissection performed in the Western setting

Sunil Gupta 
1   Gastroenterology and Hepatology, Westmead Hospital, Westmead, Australia (Ringgold ID: RIN8539)
2   Medicine, The University of Sydney Westmead Clinical School, Westmead, Australia (Ringgold ID: RIN216997)
,
Puja Kumar
1   Gastroenterology and Hepatology, Westmead Hospital, Westmead, Australia (Ringgold ID: RIN8539)
3   Division of Gastroenterology and Hepatology, University of Calgary Faculty of Medicine, Calgary, Canada (Ringgold ID: RIN70401)
,
Rocio Chacchi
4   Royal Free Unit for Endoscopy, The Royal Free Hospital, University College London Institute for Liver and Digestive Health, London, United Kingdom of Great Britain and Northern Ireland (Ringgold ID: RIN171090)
,
Alberto Murino
4   Royal Free Unit for Endoscopy, The Royal Free Hospital, University College London Institute for Liver and Digestive Health, London, United Kingdom of Great Britain and Northern Ireland (Ringgold ID: RIN171090)
,
Edward J Despott
4   Royal Free Unit for Endoscopy, The Royal Free Hospital, University College London Institute for Liver and Digestive Health, London, United Kingdom of Great Britain and Northern Ireland (Ringgold ID: RIN171090)
,
Arnaud Lemmers
5   Gastroenterology, Hepatopancreatology and Digestive Oncology, Erasme University Hospital, Université Libre de Bruxelles (ULB), Bruxelles, Belgium
,
Mathieu Pioche
6   Endoscopy Unit, Digestive Disease Department, Hôpital Edouard Herriot, Lyon, France (Ringgold ID: RIN36609)
,
Michael J. Bourke
1   Gastroenterology and Hepatology, Westmead Hospital, Westmead, Australia (Ringgold ID: RIN8539)
2   Medicine, The University of Sydney Westmead Clinical School, Westmead, Australia (Ringgold ID: RIN216997)
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Erratum zu diesem Artikel:

Correction: Duodenal neuroendocrine tumors: Short-term outcomes of endoscopic submucosal dissection performed in the Western settingEndosc Int Open 2023; 11(11): C7-C7
DOI: 10.1055/a-2219-6464

Abstract

Background and study aims Endoscopic resection (ER) is recommended for the management of duodenal neuroendocrine tumors (D-NETs) confined to the submucosal layer, without lymph node or distant metastasis. While this is accepted practice for lesions < 10 mm, consensus for larger lesions remains unclear. Although endoscopic submucosal dissection (ESD) has been proposed as the preferred ER technique for DNETs ≥10 mm, there are limited data on efficacy and safety, particularly in the Western setting.

Patients and methods We performed a retrospective analysis of patients with D-NETs who underwent ESD between 2012 and 2022 in three tertiary referral centers in Australia, France, and Belgium.

Results Fourteen patients with 15 D-NETs were evaluated. Median patient age was 64 years (interquartile range [IQR] 58–70 years). All D-NETs were confined to the duodenal bulb. Median D-NET size was 10 mm (IQR 7–12 mm) and specimen size was 15 mm (IQR 15–20 mm). Median procedure time was 60 minutes (IQR 25–90 minutes). The rate of en bloc resection was 100%. Intra-procedural perforation occurred in four patients (26.7%), with all closed endoscopically without long-term sequelae. There were no episodes of clinically significant bleeding. No local recurrence, lymph node or distant metastasis was observed at a median follow-up of 19.9 months (IQR 10.3–49.3 months).

Conclusions In experienced hands, ESD for D-NETs can achieve a 100% en bloc resection rate. There were no cases of local recurrence or distant metastatic spread, indicating that ESD may be a viable option for patients with D-NETs 10 to 15 mm that are not surgical candidates.

Keywords

Neoplasia - Quality and logistical aspects - Performance and complications - GI Pathology


Publikationsverlauf

Eingereicht: 02. April 2023

Angenommen nach Revision: 01. September 2023

Accepted Manuscript online:
25. September 2023

Artikel online veröffentlicht:
27. November 2023

© 2023. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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Kommentar zu diesem Artikel:

Endoscopy International Open – recently publishedEndoscopy 2024; 56(02): 162-162
DOI: 10.1055/a-2209-3193

 

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