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Journal Articles Neuroendocrinology Year : 2021

Management and Prognosis of Localized Duodenal Neuroendocrine Neoplasms

Servane Gay-Chevallier
  • Function : Author
Louis de Mestier
Julie Perinel
  • Function : Author
Julien Forestier
  • Function : Author
Valérie Hervieu
  • Function : Author
Philippe Ruszniewski
  • Function : Author
Ingrid Millot
  • Function : Author
Pierre-Jean Valette
  • Function : Author
Mathieu Pioche
  • Function : Author
Catherine Lombard-Bohas
  • Function : Author
Mustapha Adham
  • Function : Author
Thomas Walter

Abstract

Introduction: The characteristics, prognostic factors, and management of duodenal neuroendocrine neoplasms (dNEN) are ill-defined, given their rarity. Whether nonsurgical management might be appropriate for patients with nonmetastatic dNEN and a good prognosis, as is the case for pancreatic NEN (pNEN), is unknown. We aimed to describe the management and prognosis of nonmetastatic dNEN patients. Methods: All consecutive patients with nonmetastatic dNEN managed between 1981 and 2018 in 2 expert centers were included. Recurrence-free survival (RFS) and factors associated with recurrence were estimated. Results: A total of 145 patients with dNEN were included. Twenty-eight patients with sporadic, nonfunctioning, small (median 7 mm) dNEN underwent endoscopic resection, with a 5-year RFS rate of 89.4%. Local recurrence occurred in 2 patients, who underwent surgery with no new events. The 5-year RFS rate was 87.9% in patients who underwent surgery. Upon univariate analysis, age, size, Ki67 index, and lymph node involvement (LN+) were significantly associated with worse RFS for all dNEN treated (endoscopy/surgery); multivariate analysis found that age, size, and LN+ were associated with worse RFS. Conclusion: Selected nonmetastatic dNEN had a favorable outcome, and a less invasive therapeutic strategy appeared more suitable than oncological surgery.
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Dates and versions

hal-04179693 , version 1 (10-08-2023)

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Servane Gay-Chevallier, Louis de Mestier, Julie Perinel, Julien Forestier, Valérie Hervieu, et al.. Management and Prognosis of Localized Duodenal Neuroendocrine Neoplasms. Neuroendocrinology, 2021, 111 (8), pp.718-727. ⟨10.1159/000508102⟩. ⟨hal-04179693⟩
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