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Diagnostic features and management options for duodenal neuroendocrine neoplasms: a retrospective, multi-centre study
Duodenal neuroendocrine neoplasms (dNENs) are rare neoplasms but their incidence is on the rise. They are classified into 5 sub-types but there remains much heterogeneity in behaviour in particular of non-functioning dNENs. To retrospectively analyse outcomes for all types of dNENs, and highlight pr...
Autores principales: | , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Nature Publishing Group UK
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9492724/ https://www.ncbi.nlm.nih.gov/pubmed/36130981 http://dx.doi.org/10.1038/s41598-022-19738-9 |
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author | Mandair, Dalvinder Kamieniarz, Lukasz Pizanias, Michail Weickert, Martin O. Narayan, Akshay O’Mahony, Luke Furtado Caplin, Martyn Ramage, John Prachalias, Andreas Srirajaskanthan, Rajaventhan Toumpanakis, Christos |
author_facet | Mandair, Dalvinder Kamieniarz, Lukasz Pizanias, Michail Weickert, Martin O. Narayan, Akshay O’Mahony, Luke Furtado Caplin, Martyn Ramage, John Prachalias, Andreas Srirajaskanthan, Rajaventhan Toumpanakis, Christos |
author_sort | Mandair, Dalvinder |
collection | PubMed |
description | Duodenal neuroendocrine neoplasms (dNENs) are rare neoplasms but their incidence is on the rise. They are classified into 5 sub-types but there remains much heterogeneity in behaviour in particular of non-functioning dNENs. To retrospectively analyse outcomes for all types of dNENs, and highlight prognostic factors associated with worse outcome. 102 (57 m/45f.) patients were identified with mean age at diagnosis 62 (range 32–87) years. The majority were non-functioning tumours 87/102 and median size was 10 mm (range 0.9–130 mm). 83 patients had Stage I or II disease, of which 17 underwent endoscopic resection with R1 rate of 45% and complication rate 12%. 36 patients were kept under endoscopic surveillance. There were 11 deaths of which 4 were disease related. Age and Ki67 > 20% were associated with worse OS in all dNENs. In non-functioning dNENs Ki67 > 3% was a predictor of lymph nodes metastases with OR 18.2 (2.54–13) (p < 0.005) in univariate analyses and liver metastases with OR 6.79 (1.56–29.5) (p < 0.05) in the multivariate analysis. Lesions 11–20 mm in size had OR 11.1 (1.16–106) compared to lesions < 11 mm for the prediction of lymph node metastases in the multivariate analysis (p < 0.05). ROC analysis of size of non-functioning dNENs to predict LN metastases found < 15 mm had an AUROC of 0.9 (0.81–0.99) with a sensitivity of 85% and specificity of 88%. dNENs are increasing in incidence, however low grade and smaller lesions have an indolent course and the role of endoscopic resection and active surveillance needs to be reviewed. |
format | Online Article Text |
id | pubmed-9492724 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Nature Publishing Group UK |
record_format | MEDLINE/PubMed |
spelling | pubmed-94927242022-09-23 Diagnostic features and management options for duodenal neuroendocrine neoplasms: a retrospective, multi-centre study Mandair, Dalvinder Kamieniarz, Lukasz Pizanias, Michail Weickert, Martin O. Narayan, Akshay O’Mahony, Luke Furtado Caplin, Martyn Ramage, John Prachalias, Andreas Srirajaskanthan, Rajaventhan Toumpanakis, Christos Sci Rep Article Duodenal neuroendocrine neoplasms (dNENs) are rare neoplasms but their incidence is on the rise. They are classified into 5 sub-types but there remains much heterogeneity in behaviour in particular of non-functioning dNENs. To retrospectively analyse outcomes for all types of dNENs, and highlight prognostic factors associated with worse outcome. 102 (57 m/45f.) patients were identified with mean age at diagnosis 62 (range 32–87) years. The majority were non-functioning tumours 87/102 and median size was 10 mm (range 0.9–130 mm). 83 patients had Stage I or II disease, of which 17 underwent endoscopic resection with R1 rate of 45% and complication rate 12%. 36 patients were kept under endoscopic surveillance. There were 11 deaths of which 4 were disease related. Age and Ki67 > 20% were associated with worse OS in all dNENs. In non-functioning dNENs Ki67 > 3% was a predictor of lymph nodes metastases with OR 18.2 (2.54–13) (p < 0.005) in univariate analyses and liver metastases with OR 6.79 (1.56–29.5) (p < 0.05) in the multivariate analysis. Lesions 11–20 mm in size had OR 11.1 (1.16–106) compared to lesions < 11 mm for the prediction of lymph node metastases in the multivariate analysis (p < 0.05). ROC analysis of size of non-functioning dNENs to predict LN metastases found < 15 mm had an AUROC of 0.9 (0.81–0.99) with a sensitivity of 85% and specificity of 88%. dNENs are increasing in incidence, however low grade and smaller lesions have an indolent course and the role of endoscopic resection and active surveillance needs to be reviewed. Nature Publishing Group UK 2022-09-21 /pmc/articles/PMC9492724/ /pubmed/36130981 http://dx.doi.org/10.1038/s41598-022-19738-9 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . |
spellingShingle | Article Mandair, Dalvinder Kamieniarz, Lukasz Pizanias, Michail Weickert, Martin O. Narayan, Akshay O’Mahony, Luke Furtado Caplin, Martyn Ramage, John Prachalias, Andreas Srirajaskanthan, Rajaventhan Toumpanakis, Christos Diagnostic features and management options for duodenal neuroendocrine neoplasms: a retrospective, multi-centre study |
title | Diagnostic features and management options for duodenal neuroendocrine neoplasms: a retrospective, multi-centre study |
title_full | Diagnostic features and management options for duodenal neuroendocrine neoplasms: a retrospective, multi-centre study |
title_fullStr | Diagnostic features and management options for duodenal neuroendocrine neoplasms: a retrospective, multi-centre study |
title_full_unstemmed | Diagnostic features and management options for duodenal neuroendocrine neoplasms: a retrospective, multi-centre study |
title_short | Diagnostic features and management options for duodenal neuroendocrine neoplasms: a retrospective, multi-centre study |
title_sort | diagnostic features and management options for duodenal neuroendocrine neoplasms: a retrospective, multi-centre study |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9492724/ https://www.ncbi.nlm.nih.gov/pubmed/36130981 http://dx.doi.org/10.1038/s41598-022-19738-9 |
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