Clinical characteristics and long‐term prognosis of type 1 gastric neuroendocrine tumors in a large Japanese national cohort

DOI Web Site 参考文献35件 オープンアクセス
  • Ken Namikawa
    Department of Gastroenterology, Cancer Institute Hospital Japanese Foundation for Cancer Research Tokyo Japan
  • Tomoari Kamada
    Department of Health Care Medicine Kawasaki Medical School Okayama Japan
  • Junko Fujisaki
    Department of Gastroenterology, Cancer Institute Hospital Japanese Foundation for Cancer Research Tokyo Japan
  • Yuichi Sato
    Department of Gastroenterology Niigata University Graduate School of Medicine and Dental Sciences Niigata Japan
  • Takahisa Murao
    Department of Health Care Medicine Kawasaki Medical School Okayama Japan
  • Tsutomu Chiba
    Department of Gastroenterology and Hepatology, Graduate School of Medicine Kyoto University Kyoto Japan
  • Yasuharu Kaizaki
    Department of Pathology Fukui Prefectural Hospital Fukui Japan
  • Kenji Ishido
    Department of Gastroenterology Kitasato University School of Medicine Kanagawa Japan
  • Yutaro Ihara
    Department of Medicine and Clinical Science, Graduate School of Medical Sciences Kyushu University Fukuoka Japan
  • Koichi Kurahara
    Division of Gastroenterology Matsuyama Red Cross Hospital Ehime Japan
  • Tomoaki Suga
    Endoscopic Examination Center Shinshu University Nagano Japan
  • Haruhisa Suzuki
    Endoscopy Division National Cancer Center Hospital Tokyo Japan
  • Masanori Ito
    Department of General Internal Medicine Hiroshima University Hospital Hiroshima Japan
  • Katsuya Hirakawa
    Division of Gastroenterology Fukuoka Red Cross Hospital Fukuoka Japan
  • Yasuhiko Maruyama
    Division of Gastroenterology Fujieda Municipal General Hospital Shizuoka Japan
  • Takuji Gotoda
    Department of Gastroenterology Nihon University Hospital Tokyo Japan
  • Osamu Hosokawa
    Department of Surgery Yokohama Sakae Kyosai Hospital Kanagawa Japan
  • Tomohiro Koike
    Division of Gastroenterology Tohoku University Graduate School of Medicine Miyagi Japan
  • Katsuhiro Mabe
    Junpukai Health Maintenance Center ‐ Kurashiki Okayama Japan
  • Takashi Yao
    Department of Human Pathology Juntendo University School of Medicine Tokyo Japan
  • Kazuo Inui
    Department of Gastroenterology Yamashita Hospital Aichi Japan
  • Hiroyasu Iishi
    Department of Gastroenterology Itami City Hospital Hyogo Japan
  • Haruhiko Ogata
    Center for Diagnostic and Therapeutic Endoscopy Keio University School of Medicine Tokyo Japan
  • Takahisa Furuta
    Center for Clinical Research Hamamatsu University School of Medicine Shizuoka Japan
  • Ken Haruma
    Division of Gastroenterology, Department of Internal Medicine 2 Kawasaki Medical School Okayama Japan

抄録

<jats:sec><jats:title>Objectives</jats:title><jats:p>Optimal management of type 1 gastric neuroendocrine tumors (T1‐GNETs) remains unknown, with few reports on their long‐term prognosis. This study investigated the clinical characteristics and long‐term prognosis of T1‐GNETs.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>We reviewed the medical records of patients diagnosed with T1‐GNET during 1991–2019 at 40 institutions in Japan.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>Among 172 patients, endoscopic resection (ER), endoscopic surveillance, and surgery were performed in 84, 61, and 27, respectively, including 27, 77, and 2 patients with pT1a‐M, pT1b‐SM, and pT2 tumors, respectively. The median tumor diameter was 5 (range 0.8–55) mm. Four (2.9%) patients had lymph node metastasis (LNM); none had liver metastasis. LNM rates were significantly higher in tumors with lymphovascular invasion (LVI) (15.8%; 3/19) than in those without (1.1%; 1/92) (<jats:italic>P</jats:italic> = 0.016). For tumors <10 mm, LVI and LNM rates were 18.4% (14/76) and 2.2% (2/90), respectively, which were not significantly different from those of tumors 10–20 mm (LVI 13.3%; 2/15, <jats:italic>P</jats:italic> = 0.211; and LNM 0%; 0/17, <jats:italic>P</jats:italic> = 1.0). However, these rates were significantly lower than those of tumors >20 mm (LVI 60%; 3/5, <jats:italic>P</jats:italic> = 0.021; and LNM 40%; 2/5, <jats:italic>P</jats:italic> = 0.039). No tumor recurrence or cause‐specific death occurred during the median follow‐up of 10.1 (1–25) years. The 10‐year overall survival rate was 97%.</jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p>Type 1 gastric neuroendocrine tumors showed indolent nature and favorable long‐term prognoses. LVI could be useful in indicating the need for additional treatments. ER for risk prediction of LNM should be considered for tumors <10 mm and may be feasible for tumors 10–20 mm.</jats:p></jats:sec><jats:sec><jats:title>Trial registration</jats:title><jats:p>The study protocol was registered in the University Hospital Medical Information Network (UMIN) under the identifier UMIN000029927.</jats:p></jats:sec>

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