The Laparoscopic Approach in the Surgical Treatment of the Gastric Neuroendocrine Tumors Abstract #2042

Introduction: The incidence of G-NETs has been increased significantly over the last decades, which seems set to continue. The treatment of gastric NETs comprises a wide range of surgical approaches alone or in combination with chemotherapy and target therapy. Laparoscopic surgery is the reasonable method of choice for the partial stomach resection as well as when the gastrectomy is needed.
Aim(s): The present study was conducted to investigate efficacy and safety of laparoscopic surgery in comparison with an open approach. The complication, progression free (PFS) and overall survival (OS) were analyzed. 
Materials and methods: Forty-seven patients with G-NETs were undergone surgical treatment at the National Cancer Institute of Ukraine over the period from 1987 to 2017. There were 22 males and 25 females. Patients were divided retrospectively into two groups A (open gastric surgery) and B (laparoscopic resection) 43 and 4 patients, respectively. In group A six were overcome gastrectomy, 19 – distant subtotal gastrectomy and 18 – partial gastric resection whereas in group B all four patients were undergone proximal gastric resection and one of them with endoscopic assistance.
Conference: 15th Annual ENETS conference (2018)
Category: Surgical treatment and Ablative Therapies
Presenting Author: MD,PhD Mykola Zubaryev

To read results and conclusion, please login ...

Further abstracts you may be interested in

#14 Radioguided surgery in NET: First impression with Ga-68 labeled somatostatin analogues
Introduction: Neuroendocrine tumors (NET) constitute a heterogenous group of neoplasms. The development of Gallium-68-labeled somatostatin analogues, such as DOTA-NOC or DOTA-TOC, PET/CT have dramatically improved the diagnosis of neuroendocrine tumors. Surgery remains the treatment of choice for localized disease as well as metastatic disease. The aims of surgery are: improvement of symptoms, reduction of tumor mass / burden and to give better quality of life to patients. Recurrent laparotomies often lead to multiple adhesions and altered anatomy. So it is increasingly difficult for imaging physicians and surgeons to separate non-malignant from malignant tissue.
Conference: 7th Annual ENETS Conference (2010)
Category: Clinical
Presenting Author: Dr. Daniel Kaemmerer
#18 Long-acting release octreotide induce complete response in type 1 gastric carcinoid tumors
Introduction: Gastric endocrine tumors (GET) are increasingly recognized due to expanding indications of upper gastrointestinal endoscopy. Often silent and benign, GET may also be aggressive when sporadic and may sometimes mimic the course of gastric adenocarcinoma. Current incidence of GETs is estimated at around 8% of digestive endocrine tumors. Yearly age-adjusted incidence is around 0.2 per population of 100,000. Gastric carcinoids (ECLomas) develop from gastric enterochromaffin-like cells (ECL cells) in response to chronically elevated gastrin. Type 1 tumors (ECLomas in the course of atrophic gastritis) may occur in conditions of achlorhydria secondary to auto-immune atrophic fundic gastritis. It occurs mostly in women and they are non-functioning tumors, typically found during upper GI endoscopy performed for dyspepsia. ECLomas present frequently as multiple polyps, usually < 1 cm in diameter in the gastric fundus. Type 1 tumors are almost exclusively benign lesions with little risk of deep invasion of the gastric parietal wall. The neoplastic ECL cells become progressively dedifferentiated with an increasing number of Ki-67 immunoreactive (IR) cell nuclei. In addition, there is a substantial decrease in argynophil and IR NE cells that can be visualized by conventional methods. ECLomas secondary to hypergastrinemia should be closely followed for signs of clinical and histopathological tumor progression. Such ECLomas deserve early, active, radical surgical treatment.
Traditionally, gastric carcinoid type 1 (GCA1s) are endoscopically or surgically removed, depending on the number, appearance and size of the tumors. Antrectomy, with surgical excision of the majority of the G cells, is thought to facilitate regression of these tumors by removing the source of excessive gastrin secretion; however, the long-term benefits of antrectomy still remain uncertain. Although proton pump inhibitors are effective in reducing hypergastrinemia-induced gastric acid hypersecretion in GCA2, they do not affect ECL-cell hyperplasia, and therefore their role in GCA1 is limited. Moreover, in selected cases, significant reduction of hypergastrinemia does not prevent development of ECL carcinoid, suggesting that, in addition to hypergastrinemia, other pathogenic or genetic factors may be involved. Treatment with somatostatin analogues (SSA) might impede ECL-cell hyperplasia by suppressing gastrin secretion and/or by a direct anti-proliferative effect on ECL cells. Treatment with SSAs in GCA1 leads to a substantial tumor load reduction, with a concomitant decrease of serum gastrin levels. Published data indicate an important anti-proliferative effect of SSA on ECL cells, providing clinical benefit and obviating, at least temporarily, the need for invasive therapies for GCA1. Morphometric studies demonstrated that, while antrectomy specifically decreased the volume of ECL cells versus the total volume of endocrine cells, octreotide reduces the overall endocrine cell volume. Although the number of treated patients is small, it has been suggested that SSA may exert important anti-proliferative effects either directly, by inhibiting ECL-cells proliferation, or indirectly through suppression of gastrin hypersecretion.
Conference: 7th Annual ENETS Conference (2010)
Category: Clinical
Presenting Author: MD Ricardo Caponero
#37 Gastric GIST with synchronous neuroendocrine tumor of the pancreas, Case Report and Literature Review
Introduction: The Gastrointestinal Stromal Tumors (GIST) are the most common mesenchymal tumors of the gastrointestinal tract. These are rare tumors with an incidence of 15 new cases per million per year. They often occur in individuals over the age of 40 years, without gender predominance. The clinical behavior is variable and benign tumors are the most common. They can develop anywhere in the GI tract, but are more frequent in the stomach and small intestine. The primary treatment, when located, is the surgical resection, which can be complemented with the use of imatinib.
The occurrence of neuroendocrine tumors of the pancreas is rare, representing 1-5% of pancreatic cancers, and it is estimated that its incidence does not exceed 5 to one million. The tumors considered nonfunctioning (15-32% of pancreatic neuroendocrine tumors) are not associated with any syndrome, and are usually incidental. They have a slight predominance in males, and are more frequent in the 6th decade of life. Nonfunctioning tumors of islet cells are virtually all malignant tumors, and the treatment consists of surgical resection.
Conference: 7th Annual ENETS Conference (2010)
Category: Clinical
Presenting Author: Dra Amelia B Tavares
#51 Epidemiology of the neuroendocrine tumors diagnosed in Cardarelli Hospital: a retrospective single-institution analysis of 274 cases
Introduction: Neuroendocrine tumors (NETs) are considered rare tumors and are characterized by their ability to produce peptides that cause typical hormonal syndromes. Neuroendocrine tumors consist of a wide spectrum of malignancies with different histology that can arise from distributed neuroendocrine cells in the body. Although these tumors are frequently indolent, they can be aggressive and resistant to therapy. Its incidence in the U.S.A has been rising in the last three decades (Surveillance, Epidemiology, and End Results registry). NETs are more common than generally believed.
Conference: 7th Annual ENETS Conference (2010)
Category: Clinical
Presenting Author: Dr Ferdinando Riccardi
#73 First experience of laparoscopic treatment of organic hyperinsulinism
Introduction: Pancreatic laparoscopic surgery is the most promising type of surgery. In the case of varied benign pancreatic tumors, laparoscopic surgery can become a standard surgical procedure. Among these uncommon tumors, pancreatic insulinomas are mostly benign and solitary. Successful management of patients with insulinomas depends on accurate localization of the tumor and the use of appropriate surgical techniques.
Conference: 7th Annual ENETS Conference (2010)
Category: Basic
Presenting Author: MD, Phd Viktor Shkarban