Massironi S, Gallo C, Laffusa A, Ciuffini C, Conti CB, Barbaro F, Boskoski I, Dinelli ME, Invernizzi P. Endoscopic techniques for gastric neuroendocrine tumors: An update. World J Gastrointest Endosc 2023; 15(3): 103-113 [PMID: 37034968 DOI: 10.4253/wjge.v15.i3.103]
Corresponding Author of This Article
Sara Massironi, MD, PhD, Chief Physician, Doctor, Medical Assistant, Research Scientist, Gastroenterology Unit, Fondazione IRCCS San Gerardo dei Tintori, 33 Via G.B. Pergolesi, Monza (MB) 20900, Italy. sara.massironi@libero.it
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Minireviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Endosc. Mar 16, 2023; 15(3): 103-113 Published online Mar 16, 2023. doi: 10.4253/wjge.v15.i3.103
Endoscopic techniques for gastric neuroendocrine tumors: An update
Sara Massironi, Camilla Gallo, Alice Laffusa, Cristina Ciuffini, Clara Benedetta Conti, Federico Barbaro, Ivo Boskoski, Marco Emilio Dinelli, Pietro Invernizzi
Sara Massironi, Camilla Gallo, Pietro Invernizzi, Gastroenterology Unit, Fondazione IRCCS San Gerardo dei Tintori, Monza (MB) 20900, Italy
Alice Laffusa, Clara Benedetta Conti, Marco Emilio Dinelli, Interventional Endoscopy Unit, Fondazione IRCCS San Gerardo dei Tintori, Monza (MB) 20900, Italy
Cristina Ciuffini, Federico Barbaro, Ivo Boskoski, Digestive Endoscopy Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore di Roma, Center for Endoscopic Research Therapeutics and Training (CERTT), Roma 00168, Italy
Author contributions: Massironi S conceptualization and review; Gallo C literature search, original draft writing, review, and editing; Laffusa A and Ciuffini C literature search and original draft writing; Conti CB and Barbaro F expert opinion and supervision; Boskoski I contributed to review; Dinelli ME and Invernizzi P contributed to supervision.
Conflict-of-interest statement: Authors declare no conflict of interest for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Sara Massironi, MD, PhD, Chief Physician, Doctor, Medical Assistant, Research Scientist, Gastroenterology Unit, Fondazione IRCCS San Gerardo dei Tintori, 33 Via G.B. Pergolesi, Monza (MB) 20900, Italy. sara.massironi@libero.it
Received: September 25, 2022 Peer-review started: September 25, 2022 First decision: January 3, 2023 Revised: January 11, 2023 Accepted: February 8, 2023 Article in press: February 8, 2023 Published online: March 16, 2023
Abstract
Gastric neuroendocrine neoplasms (gNENs) are a rare type of gastric neoplasm, even if their frequency is increasing according to the latest epidemiologic revisions of the main registries worldwide. They are divided into three main subtypes, with different pathogeneses, biological behaviors, and clinical characteristics. GNEN heterogeneity poses challenges, therefore these neoplasms require different management strategies. Update the knowledge on the endoscopic treatment options to manage g-NENs. This manuscript is a narrative review of the literature. In recent years, many advances have been made not only in the knowledge of both the pathogenesis and the molecular profiling of gNENs but also in the endoscopic expertise towards innovative treatment options, which proved to be less aggressive without losing the capability of being radical. The endoscopic approach is increasingly applied in the field of gastrointestinal (GI) luminal neoplasms, and this is true not only for adenocarcinomas but also for gNENs. In particular, different techniques have been described for the endoscopic removal of suspected lesions, ranging from classical polypectomy (cold or hot snare) to endoscopic mucosal resection (both with “en bloc” or piecemeal technique), endoscopic submucosal dissection, and endoscopic full-thickness resection. GNENs comprise different subtypes of neoplasms with distinct management and prognosis. New endoscopic techniques offer a wide variety of approaches for GI localized neoplasms, which demonstrated to be appropriate and effective also in the case of gNENs. Correct evaluation of size, site, morphology, and clinical context allows the choice of tailored therapy in order to guarantee a definitive treatment.
Core Tip: Gastric neuroendocrine neoplasms (gNENs) are a rare form of gastric neoplasia, although their incidence is increasing worldwide according to recent epidemiological reviews of large registries. The heterogeneity of gNENs poses a challenge, and therefore these neoplasms require different treatment strategies. Among the possible treatment options, the endoscopic approach is increasingly used and progressively improved, with different techniques available, ranging from classical polypectomy (cold or hot snare) to endoscopic mucosal resection (both with “en bloc” and piecemeal techniques), endoscopic submucosal dissection and endoscopic full-thickness resection. In this manuscript, we have summarized all new endoscopic techniques for the treatment of gastric neuroendocrine tumors.
