Endoscopic surveillance alone is feasible and safe in type I gastric neuroendocrine neoplasms less than 10mm in diameter

Research output: Contribution to journalArticlepeer-review

  • External authors:
  • Klaire Exarchou
  • Haiyi Hu
  • Nathan A. Stephens
  • R Andrew Moore
  • Mark Kelly
  • Angela Lamarca
  • Wasat Mansoor
  • Richard Hubner
  • Howard Smart
  • Nathan R. Howes
  • D. Mark Pritchard

Abstract

Purpose
Type I gastric neuroendocrine neoplasms (g-NENs) have a low risk of metastasis and a generally favourable prognosis. Patients with small type I g-NENs (≤10mm) frequently require no treatment, whereas those with larger polyps usually undergo resection. We evaluated the safety and outcomes of endoscopic surveillance after no initial treatment in selected patients with type I g-NENs.
Methods
Retrospective analysis of type I g-NEN patients across two European Neuroendocrine Tumour Society Centers of Excellence 2003-2019.
Results
Following initial assessment, 87 of 115 patients with type I g-NEN (75 with polyps ≤10mm) received no initial treatment and underwent endoscopic surveillance. 79/87 (91%) demonstrated no clinically meaningful change in tumour size or grade over a median 62 month follow up. Only two patients developed NEN progression that required a change in management and two other patients developed gastric adenocarcinoma/high grade dysplasia; all four initially had ≥11mm g-NENs.
Conclusions
Patients with ≤10mm type I g-NENs were unlikely to develop clinically significant tumour progression and in most cases, resection was not needed. The endoscopic surveillance interval could therefore potentially be safely increased to every 2-3 years in such patients. However, lifelong surveillance is still advocated due to the additional risk of developing gastric adenocarcinoma.

Bibliographical metadata

Original languageEnglish
JournalEndocrine
Publication statusAccepted/In press - 9 Jul 2022