Endoscopic Management of Esophageal Neuroendocrine Neoplasms:Clinical Experience and Literature Review
10.3969/j.issn.1008-7125.2024.12.001
- VernacularTitle:食管神经内分泌肿瘤的内镜下治疗经验和文献回顾
- Author:
Jia YU
1
;
Shengli LIN
1
;
Wei SU
1
;
Yun WANG
1
;
Shuyu DONG
1
;
Pinghong ZHOU
1
;
Pingting GAO
1
Author Information
1. 复旦大学附属中山医院内镜中心暨内镜研究所(200032)
- Publication Type:Journal Article
- Keywords:
Endoscopic Therapy;
Esophageal Neuroendocrine Neoplasms;
Recurrence;
Metastasis;
Follow-Up
- From:
Chinese Journal of Gastroenterology
2024;29(12):705-710
- CountryChina
- Language:Chinese
-
Abstract:
Background:Esophageal neuroendocrine neoplasms(E-NENs)are rare and highly aggressive malignancies.Although endoscopic resection(ER)has demonstrated efficacy in managing gastrointestinal neuroendocrine tumors,ER for E-NENs lacks systematic evidence.Aims:To evaluate the feasibility and safety of ER in E-NENs,establish risk-stratified follow-up strategies based on tumor grade,invasion depth,and margin status,and define indications for ER.Methods:A retrospective analysis was conducted for 8 E-NEN patients treated with ER at the Endoscopy Center,Zhongshan Hospital,Fudan University from November 2017 to July 2021.The clinicopathological data,procedural parameters,adverse events,and follow-up outcomes were collected to summarize the diagnostic and therapeutic insights.Results:The cohort included 8 patients,with male-to-female ratio of 1:1;the mean age was(71.4±8.5)years.Half of the cases were incidentally detected during asymptomatic endoscopic screening.All tumors were confined to the submucosa:4 were small cell neuroendocrine carcinomas(SCNECs),and 4 were mixed neuroendocrine-non-neuroendocrine neoplasms(MiNENs).Endoscopic submucosal dissection(ESD)was performed in 6 cases and submucosal tunneling endoscopic resection(STER)in 2 cases.Self-limiting fever was reported in one case.One cases required additional surgery due to horizontal margin involving(no recurrence over 67 months follow-up).The median hospitalization was 4.5 days.With a median follow-up of 66 months,the recurrence and all-cause mortality rates were both 25.0%(2/8).Conclusions:MiNENs≤2.5 cm with complete ER exhibit favorable prognoses,whereas SCNECs with high mitotic indices or elevated Ki-67 proliferation indices correlate with poorer outcomes.Post-ER surveillance for E-NENs should meet or exceed esophageal squamous cell carcinoma standards.As the largest single-center ER cohort for E-NENs,this study provides critical evidence for minimally invasive management,though multicenter validation is needed.
