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- W2979888515 abstract "INTRODUCTION: Gastric neuroendocrine tumors vary in propensity for lymph node metastases, and this principle has guided management towards endoscopic, surgical or pharmacologic therapy. However, no consensus on optimal type of gastric surgery for gastric carcinoid and rate of recurrence or survival has been reached in North America. The goal of our study is to determine mortality and incidence of tumor recurrence among different surgical interventions for gastric neuroendocrine tumors. METHODS: All consecutive patients encountered at a tertiary referral center who underwent gastric surgery or endoscopic submucosal dissection (ESD) for biopsy proven gastric neuroendocrine tumor from April 1988 to January 2019 were entered into the study. Patients were categorized by proximal/wedge, distal/subtotal, total gastric resection, and ESD as well as by lymphadenectomy: none (D0), D1, or D2. Tumor grading was characterized as high (poorly differentiated, WHO 3) or low (well differentiated, WHO 1 & 2) as some patients preceded WHO classification. Recurrence and lymph node metastases were based on biopsy. Patient follow-up was determined by most recent encounter with gastroenterology or oncology provider within our health system. Date of decease was determined by Social Security Death Index query of all patients. RESULTS: Thirty patients were enrolled. Mean age of diagnosis was 63.9 ± 12.3 years old. Lymph node dissection practices were provider dependent but at least 62% did not have any lymphadenectomy. Mean follow up after surgery was 42.8 ± 12.8 months. Of those who underwent distal gastrectomy and ESD, no evidence of recurrence was noted. Two of 3 patients with recurrence had low grade tumors without lymphadenectomy. Mortality did not significantly vary with lymphadenectomy status (Figure 2). One 78-year-old patient did not survive post operatively after distal/subtotal gastrectomy with D1 lymphadenectomy due to sudden cardiac arrest 9 days after surgery. CONCLUSION: In our cohort, fewer gastric resections for GNETS include lymphadnectomy. Interestingly, recurrence was not statistically significantly associated with positive and negative lymph nodes or performance of lymphadenectomy. One limitation of this study is the scarcity of lymph node positive GNET." @default.
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- W2979888515 date "2019-10-01" @default.
- W2979888515 modified "2023-09-23" @default.
- W2979888515 title "1202 Long Term Outcomes Following Surgical Resection of Gastric Neuroendocrine Tumors" @default.
- W2979888515 doi "https://doi.org/10.14309/01.ajg.0000594336.93294.35" @default.
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