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.
Citation:
Shroff, S. R., Kushnir, V. M., Wani, S. B., Gupta, N., Jonnalagadda, S. S., Murad, F., ... & Azar, R. R. (2015). Efficacy of Endoscopic Mucosal Resection for Management of Small Duodenal Neuroendocrine Tumors. Surgical Laparoscopy Endoscopy & Percutaneous Techniques, 25(5), e134-e139.