Duodenal and Ampullary Carcinoid Tumors: Size Predicts Necessity for Lymphadenectomy View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2017-08

AUTHORS

Epameinondas Dogeas, John L. Cameron, Cristopher L. Wolfgang, Kenzo Hirose, Ralph H. Hruban, Martin A. Makary, Timothy A. Pawlik, Michael A. Choti

ABSTRACT

BACKGROUND: 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. METHODS: 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. RESULTS: 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). CONCLUSION: Lymph nodal involvement is common for duodenal and periampullary carcinoid tumors, particularly among those >1 cm in size; therefore, resection with lymphadenectomyfor these larger tumors is recommended. More... »

PAGES

1262-1269

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s11605-017-3448-4

DOI

http://dx.doi.org/10.1007/s11605-017-3448-4

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1085430420

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/28516311


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