Efficacy of Endoscopic Mucosal Resection for Management of Small Duodenal Neuroendocrine Tumors. Journal Article


Authors: Shroff, SR; Kushnir, VM; Wani, SB; Gupta, N; Jonnalagadda, SS; Murad, F; Early, DS; Mullady, DK; Edmundowicz, SA; Azar, RR
Article Title: Efficacy of Endoscopic Mucosal Resection for Management of Small Duodenal Neuroendocrine Tumors.
Abstract: BACKGROUND: Endoscopic mucosal resection (EMR) for small (20 mm) duodenal neuroendocrine tumors (NETs) remains controversial because of their rarity. MATERIALS AND METHODS: This is a retrospective cohort study of patients with surgically or endoscopically resected duodenal NETs from 2001 to 2011. The primary outcome is the rate of disease-free status following resection. A secondary outcome is the sensitivity of endoscopic ultrasound (EUS) in determining NET appropriateness for EMR. RESULTS: Thirty patients underwent resection of duodenal NETs (EMR 20, surgery 10). Tumor was present at the margins in 40% of EMR-resected NETs and 10% of surgically resected NETs. Five patients who underwent EMR had residual disease treated with repeat EMR (3) and surgery (2). EUS demonstrated 96% sensitivity in determining lesions limited to the submucosa. CONCLUSIONS: EMR for small duodenal NETs can be a safe and effective alternative to surgery in carefully selected patients. EUS is a useful adjunct in determining depth of invasion for duodenal NETs.
Journal Title: Surgical laparoscopy, endoscopy percutaneous techniques
ISSN: 1534-4908; 1530-4515
Publisher: Unknown  
Date Published: 2015