Di-san junyi daxue xuebao (Mar 2021)
Different surgical methods for gastrointestinal neuroendocrine tumors: comparison on efficacy and prognosis
Abstract
Objective To investigate the related risk factors affecting postoperative recurrence and recurrent metastasis in the patients with gastrointestinal neuroendocrine tumors (GI-NETs), and compare the therapeutic efficacy of different surgical methods as well as their impacts on prognosis. Methods The clinical data of 153 GI-NETs patients treated in our hospital from January 2010 to December 2019 were collected and retrospectively analyzed. The clinical characteristics and 5-year recurrence and metastasis rates were analyzed and calculated, and the prognostic factors and survival analysis was subsequently performed. In addition, the therapeutic efficacy was evaluated and compared between the endoscopic surgery and conventional surgery. Results Among the 153 GI-NETs patients, 90 were males (58.82%) and 63 females (41.18%). According to the 2010 WHO NETs classification, 114 cases (74.51%) were in G1 phases, 25 (16.34%) in G2 phases and 14 (9.15%) in G3 phases. And 112 patients (73.20%) underwent endoscopic surgery and 41 (26.80%) received conventional surgery. There were 26 cases (16.99%) experiencing recurrence and metastasis within 5 years, with the percentages of 1.31%, 3.92%, 3.27% and 8.50%, respectively in the duodenum, esophagus, stomach and rectum. The rates of recurrence and metastasis were 3.92% and 13.07% respectively in the endoscopic surgery and conventional surgery. Log-rank test results indicated that there were statistical differences in the recurrence and metastasis of GI-NETs among different ages, tumor sites, tumor sizes, pathological grades, and surgical methods (P 0.05). Conclusion Tumor size, pathological grade and presence of tumor in the margin are independent risk factors for postoperative recurrence and metastasis. GI-NETs in G1 and G2 phases less than 2 cm can be resected under endoscopy.
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