Brief Article
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World J Gastroenterol. Dec 14, 2013; 19(46): 8703-8708
Published online Dec 14, 2013. doi: 10.3748/wjg.v19.i46.8703
Long-term follow up of endoscopic resection for type 3 gastric NET
Yong Hwan Kwon, Seong Woo Jeon, Gwang Ha Kim, Jin Il Kim, Il-Kwun Chung, Sam Ryong Jee, Heung Up Kim, Geom Seog Seo, Gwang Ho Baik, Kee Don Choi, Jeong Seop Moon
Yong Hwan Kwon, Seong Woo Jeon, Department of Internal Medicine, Kyungpook National University Hospital, Daegu 702-210, South Korea
Gwang Ha Kim, Department of Internal Medicine, Busan National University School of Medicine, Busan 602-739, South Korea
Jin Il Kim, Department of Internal Medicine, Catholic University of Korea College of Medicine, Seoul 137-701, South Korea
Il-Kwun Chung, Department of Internal Medicine, Soonchunhyang University, Cheonan 330-721, South Korea
Sam Ryong Jee, Department of Internal Medicine, Inje University Pusan Paik Hospital, Busan 614-735, South Korea
Heung Up Kim, Department of Internal Medicine, Jeju National University School of Medicine, Jeju 690-767, South Korea
Geom Seog Seo, Department of Internal Medicine, Digestive Disease Research Institute, Wonkwang University College of Medicine, Iksan 570-749, South Korea
Gwang Ho Baik, Department of Internal Medicine, Hallym University College of Medicine, Chuncheon 200-704, South Korea
Kee Don Choi, Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul 138-736, South Korea
Jeong Seop Moon, Department of Internal Medicine, Inje University Seoul Paik Hospital, Seoul 100-032, South Korea
Author contributions: Kwon YH, Jeon SW, Kim GH and Moon JS made substantial contributions to conception and design, as well as data acquisition; Kim JI, Chung IL and Ji SR were responsible for data analysis and interpretation; Kim HU, Jeon SW and Seo GS drafted the article and/or critically revised it for important intellectual content; and Moon JS, Choi KD and Baik GH intensely reviewed and gave final approval of the manuscript version to be published.
Correspondence to: Jeong Seop Moon, PhD, Department of Internal Medicine, Inje University Seoul Paik Hospital, Mareunnae-ro 9, Jung-gu, Seoul 100-032, South Korea. moonjs2@unitel.co.kr
Telephone: +82-2-22700012 Fax: +82-2-22794021
Received: June 11, 2013
Revised: September 27, 2013
Accepted: October 19, 2013
Published online: December 14, 2013
Processing time: 189 Days and 18.6 Hours
Abstract

AIM: To clarify the short and long-term results and to prove the usefulness of endoscopic resection in type 3 gastric neuroendocrine tumors (NETs).

METHODS: Of the 119 type 3 gastric NETs diagnosed from January 1996 to September 2011, 50 patients treated with endoscopic resection were enrolled in this study. For endoscopic resection, endoscopic mucosal resection (EMR) or endoscopic submucosal dissection (ESD) was used. Therapeutic efficacy, complications, and follow-up results were evaluated retrospectively.

RESULTS: EMR was performed in 41 cases and ESD in 9 cases. Pathologically complete resection was performed in 40 cases (80.0%) and incomplete resection specimens were observed in 10 cases (7 vs 3 patients in the EMR vs ESD group, P = 0.249). Upon analysis of the incomplete resection group, lateral or vertical margin invasion was found in six cases (14.6%) in the EMR group and in one case in the ESD group (11.1%). Lymphovascular invasions were observed in two cases (22.2%) in the ESD group and in one case (2.4%) in the EMR group (P = 0.080). During the follow-up period (43.73; 13-60 mo), there was no evidence of tumor recurrence in either the pathologically complete resection group or the incomplete resection group. No recurrence was reported during follow-up. In addition, no mortality was reported in either the complete resection group or the incomplete resection group for the duration of the follow-up period.

CONCLUSION: Less than 2 cm sized confined submucosal layer type 3 gastric NET with no evidence of lymphovascular invasion, endoscopic treatment could be considered at initial treatment.

Keywords: Stomach; Neuroendocrine tumor; Endoscopic resection; Treatment; Carcinoid

Core tip: Endoscopic treatment was suitable for tumors measuring approximately 20 mm or smaller in size, with no lymph node or distant metastasis and limited to the submucosal layer of type 3 gastric neuroendocrine tumors (NETs), similar to endoscopic treatment guidelines applied to other gastrointestinal NETs.