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01-09-2018 | Review Article

Outcomes of Surgical and Endoscopic Resection of Duodenal Neuroendocrine Tumours (NETs): a Systematic Review of the Literature

Authors: Bobby V. M. Dasari, Sarah Al-Shakhshir, Timothy M. Pawlik, Tahir Shah, Ravi Marudanayagam, Robert P. Sutcliffe, Darius F. Mirza, Paolo Muiesan, Keith J. Roberts, John Isaac

Published in: Journal of Gastrointestinal Surgery | Issue 9/2018

Abstract

Introduction

Duodenal neuroendocrine tumours (dNETs) comprise about 2% of all the NETs. Treatment of dNETs involves resection of the tumour either by endoscopic or surgical resection. Surgical or endoscopic local resection of the lesion is usually a more conservative and less morbid option compared with a more radical pancreaticoduodenectomy. However, inadequate clearance by local resection might result in recurrent disease with reduced overall survival.

Methods

The current systematic review compared the differences in outcomes of endoscopic resection (ER), local resection (LR) and pancreaticoduodenectomy (PD) in the management of dNETs. Searches were performed on MEDLINE, PubMed, Embase and Cochrane databases using MeSH keyword combinations: ‘duodenal’, AND, ‘neuroendocrine tumours’. All relevant articles published up to 2016 were included. Post-operative morbidity, R0 resection status and recurrence rates were the outcomes assessed.

Results

Eight non-randomised retrospective studies with 335 participants were included (LR = 122; PD = 118; ER = 64). While PD was associated with higher morbidity compared with LR (27/64 vs. 10/74; P = 0.002), PD was associated with a higher incidence of an R0 resection (3/97 vs. 15/97; P = 0.007) as well as lower recurrence rates (3/51 vs. 6/46; P = 0.21). ER was associated with a higher positive resection margin status versus LR (22/51 vs. 14/91; P = 0.0002). Recurrence at follow-up was not different among patients with dNETs who underwent PD versus LR.

Conclusions

Radical surgical resection in the form of PD was associated with higher post-operative morbidity among patients with dNETs yet provided better margin clearance. Patients with dNETs need systematic evaluation with a view to obtain most of the information about the prognostic factors in order to tailor the treatment options.

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Title: Outcomes of Surgical and Endoscopic Resection of Duodenal Neuroendocrine Tumours (NETs): a Systematic Review of the Literature
Authors: Bobby V. M. Dasari
Sarah Al-Shakhshir
Timothy M. Pawlik
Tahir Shah
Ravi Marudanayagam
Robert P. Sutcliffe
Darius F. Mirza
Paolo Muiesan
Keith J. Roberts
John Isaac
Publication date: 01-09-2018
Publisher: Springer US
Published in: Journal of Gastrointestinal Surgery / Issue 9/2018
Print ISSN: 1091-255X
Electronic ISSN: 1873-4626
DOI: https://doi.org/10.1007/s11605-018-3825-7

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Outcomes of Surgical and Endoscopic Resection of Duodenal Neuroendocrine Tumours (NETs): a Systematic Review of the Literature

Abstract

Introduction

Methods

Results

Conclusions

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Introduction

Methods

Results

Conclusions

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