Japan Digestive Disease Week 2025
International Poster Session1 (JDDW)
October 31, 9:30–10:18, Room 15 (Kobe International Exhibition Hall No.1 Building Digital Poster Venue)
IP-1_E
Endoscopic Resection for Duodenal NETs: A single Tertiary Referral Center Experience, Retrospective Review
- 1
- Department of Internal Medicine, Pusan National University School of Medicine and Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital
Background
With advancements in high-resolution videoendoscopy and increased screening, incidental detection of small duodenal neuroendocrine tumors (D-NETs) has risen. The optimal treatment-radical surgical resection or local excision, including endoscopic resection-remains debated. Various endoscopic techniques are used based on tumor characteristics, and current guidelines recommend endoscopic resection for D-NETs <10 mm. This study evaluates the feasibility of diagnostic endoscopic resection for grade 1 or 2 D-NETs, considering recent therapeutic advancements.
Methods
We retrospectively analyzed 40 grade 1 or 2 D-NETs diagnosed at a single tertiary referral center between January 2009 and July 2023, evaluating outcomes such as histopathology, complete resection, and lymph node metastasis rates.
Results
The mean follow-up period was 59.0±6.8 months, and the average NET size was 7.4±0.8 mm, with 80% of tumors being smaller than 10 mm. The largest NET measured 25 mm. Most NETs were grade 1 (90%). Initially, only 17.5% of patients underwent surgical treatment. After endoscopic treatment, two additional surgical resections were performed, revealing no lymph node metastasis. No patients exhibited lymph node metastasis or local recurrence. Among endoscopic resections, ligation-assisted EMR achieved a 100% complete resection rate. One case of iatrogenic perforation occurred but was successfully managed with endoscopic clip closure.
Conclusions
Small-sized grade 1 and 2 D-NETs showed no lymph node or distant metastases. Diagnostic endoscopic resection could be recommended for these tumors, with ligation-assisted EMR preferred for those smaller than 10 mm.
With advancements in high-resolution videoendoscopy and increased screening, incidental detection of small duodenal neuroendocrine tumors (D-NETs) has risen. The optimal treatment-radical surgical resection or local excision, including endoscopic resection-remains debated. Various endoscopic techniques are used based on tumor characteristics, and current guidelines recommend endoscopic resection for D-NETs <10 mm. This study evaluates the feasibility of diagnostic endoscopic resection for grade 1 or 2 D-NETs, considering recent therapeutic advancements.
Methods
We retrospectively analyzed 40 grade 1 or 2 D-NETs diagnosed at a single tertiary referral center between January 2009 and July 2023, evaluating outcomes such as histopathology, complete resection, and lymph node metastasis rates.
Results
The mean follow-up period was 59.0±6.8 months, and the average NET size was 7.4±0.8 mm, with 80% of tumors being smaller than 10 mm. The largest NET measured 25 mm. Most NETs were grade 1 (90%). Initially, only 17.5% of patients underwent surgical treatment. After endoscopic treatment, two additional surgical resections were performed, revealing no lymph node metastasis. No patients exhibited lymph node metastasis or local recurrence. Among endoscopic resections, ligation-assisted EMR achieved a 100% complete resection rate. One case of iatrogenic perforation occurred but was successfully managed with endoscopic clip closure.
Conclusions
Small-sized grade 1 and 2 D-NETs showed no lymph node or distant metastases. Diagnostic endoscopic resection could be recommended for these tumors, with ligation-assisted EMR preferred for those smaller than 10 mm.
- Index Term 1: Duodenal NET
- Index Term 2: Endoscopic resection