Skip to main content
SpringerLink
Log in

Comparable long-term survival outcomes of endoscopic therapy versus surgical therapy for T1-2N0M0 duodenal neuroendocrine tumors

  • Published:
Surgical Endoscopy Aims and scope Submit manuscript

Abstract

Background and study aims

The optimal treatment modality for T1-2N0M0 duodenal neuroendocrine tumors (DNETs) is still controversial. In this study, long-term survival outcomes were compared between the endoscopic therapy and surgical therapy for T1-2N0M0 DNETs using the Surveillance, Epidemiology, and End Results (SEER) database.

Patients and methods

Patients with DNETs from the SEER database were selected from 2004 to 2015. We used the Kaplan–Meier method and log-rank test to compare long-term survival results between the endoscopic therapy and surgical therapy. An analysis of the multivariable Cox proportional hazards model was performed to identify risk factors for patient prognoses. The 1:1 propensity score matching (PSM) was performed to balance baseline data.

Results

A total of 816 patients with DNETs were included, of which 578 patients (70.8%) received endoscopic therapy and 238 patients (29.2%) received surgical therapy. Before the PSM, there was no difference between the two groups of patients with DNETs on long-term survival [5-year OS (86.1% vs. 87.9%, P = 0.45), 10-year OS (72.5% vs. 72.3%, P = 0.45)]. After adjusting covariates, we found endoscopic therapy and surgical therapy groups had comparable risks of overall survival (HR 0.86, 95% CI 0.60–1.23, P = 0.409) and cancer-specific survival (HR 1.68, 95% CI 0.74–3.83, P = 0.214). In the post-PSM analysis, there was no discernible difference between the endoscopic therapy and surgical therapy group.

Conclusions

Our study found that for T1-2N0M0 DNETs patients, whose long-term OS and CSS results were similar for the endoscopic and surgical therapy groups. For these patients, endoscopic resection might be an optimal therapy modality.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Cives M, Strosberg JR (2018) Gastroenteropancreatic Neuroendocrine Tumors. CA Cancer J Clin 68:471–487

    Article  PubMed  Google Scholar 

  2. Nagtegaal ID, Odze RD, Klimstra D, Paradis V, Rugge M, Schirmacher P, Washington KM, Carneiro F, Cree IA (2020) The 2019 WHO classification of tumours of the digestive system. Histopathology 76:182–188

    Article  PubMed  Google Scholar 

  3. Modlin IM, Lye KD, Kidd M (2003) A 5-decade analysis of 13,715 carcinoid tumors. Cancer 97:934–959

    Article  PubMed  Google Scholar 

  4. Shah MH, Goldner WS, Benson AB, Bergsland E, Blaszkowsky LS, Brock P, Chan J, Das S, Dickson PV, Fanta P, Giordano T, Halfdanarson TR, Halperin D, He J, Heaney A, Heslin MJ, Kandeel F, Kardan A, Khan SA, Kuvshinoff BW, Lieu C, Miller K, Pillarisetty VG, Reidy D, Salgado SA, Shaheen S, Soares HP, Soulen MC, Strosberg JR, Sussman CR, Trikalinos NA, Uboha NA, Vijayvergia N, Wong T, Lynn B, Hochstetler C (2021) Neuroendocrine and adrenal tumors, version 2.2021, NCCN clinical practice guidelines in oncology. J Natl Compr Canc Netw 19:839–868

    Article  CAS  PubMed  Google Scholar 

  5. Nishio M, Hirasawa K, Ozeki Y, Sawada A, Ikeda R, Fukuchi T, Kobayashi R, Makazu M, Sato C, Maeda S (2020) Short- and long-term outcomes of endoscopic submucosal dissection for non-ampullary duodenal neuroendocrine tumors. Ann Gastroenterol 33:265–271

    PubMed  PubMed Central  Google Scholar 

  6. Matsueda K, Kanesaka T, Kitamura M, Shichijo S, Maekawa A, Yamamoto S, Takeuchi Y, Higashino K, Uedo N, Michida T, Honma K, Miyashiro I, Ishihara R (2021) Favorable long-term outcomes of endoscopic resection for nonampullary duodenal neuroendocrine tumor. J Gastroenterol Hepatol 36:3329–3336

    Article  PubMed  Google Scholar 

  7. Ahmed M (2020) Gastrointestinal neuroendocrine tumors in 2020. World J Gastrointest Oncol 12:791–807

    Article  PubMed  PubMed Central  Google Scholar 

  8. Folkestad O, Wasmuth HH, Mjønes P, Fougner R, Hauso Ø, Fossmark R (2021) Survival and disease recurrence in patients with duodenal neuroendocrine tumours-a single centre cohort. Cancers (Basel) 13:3985

    Article  PubMed  Google Scholar 

  9. Dasari BVM, Al-Shakhshir S, Pawlik TM, Shah T, Marudanayagam R, Sutcliffe RP, Mirza DF, Muiesan P, Roberts KJ, Isaac J (2018) Outcomes of surgical and endoscopic resection of duodenal neuroendocrine tumours (NETs): a systematic review of the literature. J Gastrointest Surg 22:1652–1658

    Article  PubMed  Google Scholar 

  10. DelleFave G, O’Toole D, Sundin A, Taal B, Ferolla P, Ramage JK, Ferone D, Ito T, Weber W, Zheng-Pei Z, De Herder WW, Pascher A, Ruszniewski P (2016) ENETS consensus guidelines update for gastroduodenal neuroendocrine neoplasms. Neuroendocrinology 103:119–124

    Article  CAS  Google Scholar 

  11. Gay-Chevallier S, de Mestier L, Perinel J, Forestier J, Hervieu V, Ruszniewski P, Millot I, Valette PJ, Pioche M, Lombard-Bohas C, Subtil F, Adham M, Walter T (2021) Management and prognosis of localized duodenal neuroendocrine neoplasms. Neuroendocrinology 111:718–727

    Article  CAS  PubMed  Google Scholar 

  12. Gaspar JP, Stelow EB, Wang AY (2016) Approach to the endoscopic resection of duodenal lesions. World J Gastroenterol 22:600–617

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  13. Uchima H, Diez-Caballero A, Capdevila J, Rosinach M, Mata A, Turró R, Espinós J (2022) Underwater endoscopic mucosal resection for en bloc resection of a neuroendocrine tumor in the duodenal bulb. Endoscopy 54:E264-e265

    Article  PubMed  Google Scholar 

  14. Sonthalia N, Shah BB, Goenka MK (2022) Flat-based over-the-scope clip-assisted endoscopic full-thickness resection of a duodenal neuroendocrine tumour: a safe alternative to endoscopic submucosal dissection. Endoscopy 54:E391-e393

    Article  PubMed  Google Scholar 

  15. Ragheb J, Mony S, Klapman J, Erim T, Reagan A, Butler R, Dong Y, Cruise M, Centeno BA, Bejarano P, Stevens T, Hayat U, Bhatt A (2021) Impact of margin status on outcomes after endoscopic resection of well-differentiated duodenal neuroendocrine tumors. Gastrointest Endosc 94:580–588

    Article  PubMed  Google Scholar 

  16. Nabi Z, Ramchandani M, Asif S, Basha J, Chavan R, Darisetty S, Reddy N (2022) Outcomes of endoscopic submucosal dissection in duodenal neuroendocrine tumors. J Gastrointest Surg 26:275–277

    Article  PubMed  Google Scholar 

  17. Brito HP, Torres IT, Turke KC, Parada AA, Waisberg J, Botelho RV (2021) Comparison of endoscopic resection techniques for duodenal neuroendocrine tumors: systematic review. Endosc Int Open 9:E1214-e1221

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Acknowledgements

Not appliable.

Funding

The Foundation of Jiangxi provincial department of Science and Technology (Grant No. 20223BCG74011, PI: Youxiang Chen); This study was supported by Interdisciplinary Innovation Fund of Natural Science, NanChang University ( NCUIIF,Grant No.9167–27060003-YB2109, PI:Chunyan Zeng). All funders provided support to authors and paid the fee for statistical analysis.

Author information

Author notes

  1. Zide Liu and Jiaxin Gao have equally contributed to this work.

Authors and Affiliations

  1. Department of Gastroenterology, Digestive Disease Hospital, The First Affiliated Hospital of Nanchang University, 17 Yongwaizheng Street, Nanchang, 330006, Jiangxi, China

    Zide Liu, Jiaxin Gao, Peng Wang, Fang Yin, Chunyan Zeng & Youxiang Chen

  2. Jiangxi Provincial Key Laboratory of Interdisciplinary Science, Nanchang University, Nanchang, 330006, Jiangxi, China

    Chunyan Zeng

Authors
  1. Zide Liu
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Jiaxin Gao
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Peng Wang
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Fang Yin
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Chunyan Zeng
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Youxiang Chen
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding authors

Correspondence to Chunyan Zeng or Youxiang Chen.

Ethics declarations

Disclosures

Zide Liu, Jiaxin Gao, Peng Wang, Fang Yin, Chunyan Zeng, Youxiang Chen have no conflicts of interest or financial ties to disclose.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary Information

Below is the link to the electronic supplementary material.

Supplementary file1 (TIFF 625 KB)—Histogram of PSM

Supplementary file2 (DOCX 17 KB)

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Liu, Z., Gao, J., Wang, P. et al. Comparable long-term survival outcomes of endoscopic therapy versus surgical therapy for T1-2N0M0 duodenal neuroendocrine tumors. Surg Endosc 37, 5444–5452 (2023). https://doi.org/10.1007/s00464-023-10019-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00464-023-10019-8

Keywords

Search

Navigation