Duodenal and Ampullary Carcinoid Tumors: Size Predicts Necessity for Lymphadenectomy

Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract
Epameinondas DogeasMichael A Choti

Abstract

Unlike other neuroendocrine tumors of the gastrointestinal tract, management of duodenal and periampullary carcinoids remains controversial. We aimed to determine the metastatic potential and optimal choice of therapy for these neoplasms. A retrospective review of all patients treated at the Johns Hopkins Hospital between 1996 and 2012 was conducted. Clinicopathologic factors associated with lymph nodal involvement and clinical outcomes were evaluated. A total of 101 patients were identified. Eighty (79.2%) tumors arose from the duodenum and 21 (20.8%) from the periampullary area. Thirty-five (34.7%) patients underwent pancreaticoduodenectomy (PD), 12 (11.9%) local resection, 38 (37.6%) endoscopic excision, and 16 (15.8%) patients harbored incidental tumors identified in the specimen after PD for another indication. Lymph node (LN) pathologic evaluation was done in 56 patients, among which 27 (48%) had positive LN. Specifically, LN positivity (LN+) for tumors <1 cm in size was 4.5% (1/22), for tumors 1-2 cm 72% (13/18), and for tumors >2 cm 81% (13/16). Tumor size was the only factor associated with LN+ (p = 0.029). Lymph nodal involvement is common for duodenal and periampullary carcinoid tumors, particularly among those >1 cm...Continue Reading

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Citations

Nov 5, 2019·Journal of Surgical Oncology·Xu-Feng ZhangUNKNOWN other members of the US Neuroendocrine Tumor Study Group
Apr 26, 2020·Digestive Endoscopy : Official Journal of the Japan Gastroenterological Endoscopy Society·Shingo KanajiYoshihiro Kakeji
Mar 13, 2018·Reviews in Endocrine & Metabolic Disorders·Riccardo AriottiMassimo Falconi
May 5, 2018·Scandinavian Journal of Gastroenterology·Roberta Elisa RossiSara Massironi
Feb 23, 2019·World Journal of Gastrointestinal Endoscopy·Ammar B NassriBruno de Souza Ribeiro
Oct 18, 2019·Journal of Surgical Oncology·Adriana C GamboaShishir K Maithel
Aug 27, 2018·Annals of Surgical Oncology·Sara Massironi, Roberta Elisa Rossi
Aug 21, 2020·Clinical Journal of Gastroenterology·Yasutoshi ShiratoriKatsuyuki Fukuda
Jul 29, 2018·Annals of Surgical Oncology·Sara MassironiDario Conte
Sep 12, 2020·Digestive and Liver Disease : Official Journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver·Valentina AndreasiMassimo Falconi
Feb 24, 2020·European Journal of Surgical Oncology : the Journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology·Anna NießenOliver Strobel
Mar 3, 2021·Journal of Endocrinological Investigation·R E RossiUNKNOWN ItaNet (Italian Association for Neuroendocrine Tumours) study group
Mar 20, 2021·VideoGIE : an Official Video Journal of the American Society for Gastrointestinal Endoscopy·Shou-Jiang Tang
Apr 1, 2021·Journal of Gastrointestinal Cancer·Nitin Vashistha, Dinesh Singhal
Aug 21, 2021·The Journal of Surgical Research·Yuki FujiiNaruhiko Ikoma
Sep 14, 2021·Annals of Surgical Oncology·Catherine G TranJames R Howe

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