Survival and Disease Recurrence in Patients with Duodenal Neuroendocrine Tumours—A Single Centre Cohort
by
Oddry Folkestad
1,2, 
Hans H. Wasmuth
3,
Patricia Mjønes
3,4,
Reidun Fougner
5,
Øyvind Hauso
3,6 and
Reidar Fossmark
3,6,* 1
Department of Gastrointestinal Surgery, St. Olav’s Hospital, Trondheim University Hospital, 7030 Trondheim, Norway
2
Department of Gastrointestinal Surgery, Vestfold Hospital, 3103 Tønsberg, Norway
3
Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), 7030 Trondheim, Norway
4
Department of Pathology, St. Olav’s Hospital, Trondheim University Hospital, 7030 Trondheim, Norway
5
Department of Radiology, St. Olav’s Hospital, Trondheim University Hospital, 7030 Trondheim, Norway
6
Department of Gastroenterology and Hepatology, St. Olav’s Hospital, Trondheim University Hospital, 7030 Trondheim, Norway
*
Author to whom correspondence should be addressed.
Cancers 2021, 13(16), 3985; https://doi.org/10.3390/cancers13163985
Submission received: 7 June 2021
/
Revised: 2 August 2021
/
Accepted: 4 August 2021
/
Published: 6 August 2021
(This article belongs to the Special Issue Surgical Treatment of Gastrointestinal Cancers)
Simple Summary
Neuroendocrine tumours of the upper part of the small intestine are rare. They are slow growing but may spread to lymph nodes or other organs already when the tumours are small. Such tumours may be treated by endoscopic removal or by an operation. In the current study we present the treatment results of 32 patients with this rare tumour. We found that the long-term survival was long, and patients more often died from other diseases. The survival was associated with the growth rate of the tumours and whether all the tumour tissue could be removed. Endoscopic removal was sufficient for smaller tumours <10 mm, whereas a high proportion of tumours 10–20 mm have lymph node metastases that must be removed by an operation to make patients tumour free. None of the tumours that were perceived as cured after removal recurred after an average follow-up time of 4.8 years.
Abstract
Background: Duodenal neuroendocrine tumours (D-NETs) are rare but increasingly diagnosed. This study aimed to assess the overall survival and recurrence rate among patients treated for D-NETs. Methods: Patients with D-NETs were retrospectively reviewed with a median follow-up time of 4.8 years (range 0.0–17.2 years). Results: A total of 32 patients with median age 68.0 years were identified. Fifteen patients underwent surgery while ten patients underwent endoscopic treatment. Mean estimated overall survival for the entire population was 12.1 years (95% CI 9.5–14.7 years), while 5-year overall survival was 81.3%. Tumour grade G1 was associated with longer mean estimated survival compared to G2 tumours (13.2 years versus 4.4 years, p = 0.010). None of the 23 patients who underwent presumed radical endoscopic or surgical resection had disease recurrence during follow-up. Tumours <10 mm could be treated endoscopically whereas a high proportion of patients with tumours 10–20 mm should be considered for surgery. Conclusion: Patients with D-NETs had long overall survival, and mortality was more influenced by other diseases. Both endoscopic and surgical resections were effective as no recurrences were diagnosed during follow-up.
Keywords:
neuroendocrine tumour; duodenum; endoscopy; surgery; survival; recurrence; outcome
