Risk factors for lymph node metastasis and survival of patients with nonampullary duodenal carcinoid tumors treated with endoscopic therapy versus surgical resection: analysis of the Surveillance, Epidemiology, and End Results program

• Published in: Gastrointestinal endoscopy 2021-06, Vol.93 (6), p.1384-1392
• Main Authors: Wang, Rui, Mohapatra, Sonmoon, Jovani, Manol, Akshintala, Venkata S., Kamal, Ayesha, Brewer, Olaya Gutierrez, Kumbhari, Vivek, Shin, Eun Ji, Canto, Marcia I., Khashab, Mouen A., Singh, Vikesh K., Lennon, Anne Marie, Kalloo, Anthony Nicholas, Ngamruengphong, Saowanee
• Format: Article
• Language: English
• ISSN: 0016-5107; 1097-6779
• DOI: 10.1016/j.gie.2020.12.012

Endoscopic therapy (ET) has been used to treat nonampullary duodenal neuroendocrine tumors (NAD-NETs) ≤10 mm in size, but data on long-term outcomes are limited. In addition, management of 11- to 19-mm NAD-NETs is not well defined because of variable estimates of risk of metastasis. We aimed to determine the prevalence and risk factors of metastasis of NAD-NETs ≤19 mm and evaluate the long-term survival of patients after ET as compared with radical surgery. The Surveillance Epidemiology and End Result database was used to identify 1243 patients with T1-2 histologically confirmed NAD-NETs ≤19 mm in size. Cancer-specific survival (CSS) and overall survival (OS) were calculated. Overall, 4.8% of cases had metastasis at the time of diagnosis, with lower prevalence in ≤10-mm lesions (3.1%) versus 11- to 19-mm lesions (11.7%, P < .001). The risk factors for metastases included invasion to the muscularis propria (odds ratio, 25.95; 95% confidence interval, 9.01-76.70), age