Pathologic Grade and Tumor Size are Associated with Recurrence-Free Survival in Patients with Duodenal Neuroendocrine Tumors
Pathologic Grade and Tumor Size are Associated with Recurrence-Free Survival in Patients with Duodenal Neuroendocrine Tumors
复制标题
DOI：
10.1007/s11605-014-2456-x
复制
发表时间：
2014-03-01
影响因子：
3.2
通讯作者：
Tang, Laura H.
中科院分区：
文献类型：
--
作者：
Untch, Brian R.;Bonner, Keisha P.;Tang, Laura H.
背景十二指肠神经内分泌肿瘤是罕见的，很少有研究指导外科治疗。本研究确定了与复发相关的因素后recruitment.Methods一个回顾性的，单一的机构进行审查，1983年至2011年之间的病理诊断为十二指肠神经内分泌肿瘤的患者。根据WHO 2010标准（Ki-67和核分裂率）进行肿瘤分级。其中包括12例内镜粘膜切除术患者，34例局部切除术患者，29例接受胰腺切除术患者。2年和5年无复发生存率分别为84%和81%。有11例肿瘤复发（局部或远处），4例患者死于疾病（3/4例有高级别病变），总体中位随访时间为27个月。在单变量分析中，肿瘤大小和肿瘤分级与复发相关，但与介入类型、淋巴结转移、壶腹位置或边缘状态无关。结论肿瘤分级和大小与十二指肠神经内分泌肿瘤的无复发生存率相关。在可行的情况下，应考虑采用侵略性较小的手术方法治疗低级别和低阶段的十二指肠NET。
Background Duodenal neuroendocrine tumors are rare and few studies exist to guide surgical management. This study identifies factors associated with recurrence after resection.Methods A retrospective, single institution review was performed between 1983 and 2011 on patients with a pathologic diagnosis of duodenal neuroendocrine tumor. Tumor grade was assigned based on WHO 2010 criteria (Ki-67 and mitotic rate).Results Seventy-five patients were identified that underwent curative resection. This included 12 patients with endoscopic mucosal resection, 34 that had local resection, and 29 that underwent pancreaticoduodenectomy. Two-year and 5-year recurrence-free survival was 84 and 81 %, respectively. There were 11 tumor recurrences (either local or distant), and four patients died of their disease (3/4 had high-grade lesions) with an overall median follow-up of 27 months. On univariate analysis, tumor size and tumor grade were identified as being associated with recurrence, but not intervention type, lymph node metastases, ampullary location, or margin status.Conclusions Tumor grade and size are associated with recurrence-free survival in duodenal neuroendocrine tumors. When feasible, a less aggressive surgical approach to treat low-grade and low-stage duodenal NETs should be considered.