Background: Gastric and duodenal neuroendocrine tumours are increasing in incidence. ENETS guidelines suggest endoscopic resection of type 1 gastric NENs over 10 mm and consider endoscopic resection for duodenal NENs. However, the endoscopic techniques are not clearly mandated. There, is evidence to suggest endoscopic mucosal dissection has higher incidence of R0 resections compared with polypectomy or EMR alone. We have reviewed our data of endoscopic resection of gastro-duodenal NENs using EMR and ESD.
Methods: A retrospective review was performed of 78 patients with gastro-duodenal NENs referred to our institution between 2014 and 2019. Data was collected from medical records of patients who underwent endoscopic resection of these lesions.
Results: 14 of 78 patients underwent endoscopic resection (7 duodenal NEN and 7 gastric NENs). There were no perforations and no mortality or morbidity within 30 days. All patients who underwent endoscopic resection are still alive. Of the 7 duodenal NENs, 3 patients had ESD with R0 resections. 4 patients underwent EMR or hybrid procedures, 50% R0 resection. 7 gastric NENs resected 3 ESD, with R0 resections. 4 EMR resection, 1 R0 resection (two of these resections were performed at external hospitals).
Conclusion: Endoscopic therapy for small duodenal and gastric NENs can be performed safely by expert endoscopists. ESD appears to offer a higher R0 resection rate than EMR.
02 Dec 2019
UK and Ireland Neuroendocrine Tumour Society