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- W3058476177 endingPage "148" @default.
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- W3058476177 abstract "Gastroenteropancreatic neuroendocrine neoplasms (GEP-NENs) with favorable pathological and clinical features may be considered as indolent lesions, and therefore be amenable to conservative management. According to the primary tumor site, different non-aggressive approaches, based on endoscopic resection or simple active surveillance, can be proposed to selected patients fulfilling specific criteria. Tumor size, Ki67 proliferative index and depth of invasion are markers that can be used in order to identify these subjects. Patients with type I gastric NENs <1 cm as well as those with non-ampullary duodenal NENs <1 cm with no associated syndrome can be safely managed by endoscopic resection. On the other hand, an active surveillance approach is preferred over surgery for patients with asymptomatic, non-functioning pancreatic NENs ≤2 cm without dilation of the main pancreatic duct or bile duct. As far as NENs of the appendix are concerned, appendectomy should be considered as curative when a R0 resection has been achieved in the presence of a tumor ≤1.5 cm, graded as G1 and without lymphovascular invasion. Finally, G1 rectal NENs ≤1 cm without invasion of the muscular layer can be safely treated by endoscopic resection. Therefore, surgeons should be aware of the existence of indolent GEP-NENs, in order to avoid unnecessary operations with associated postoperative complications. • GEP-NENs with specific clinico-pathological features can be considered as indolent. • Surgeons should be aware of the existence of GEP-NENs not requiring surgery. • A treatment based on endoscopic resection or active surveillance can be proposed." @default.
- W3058476177 created "2020-08-24" @default.
- W3058476177 creator A5001378606 @default.
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- W3058476177 date "2020-12-01" @default.
- W3058476177 modified "2023-10-02" @default.
- W3058476177 title "Gastro-entero-pancreatic neuroendocrine neoplasia: The rules for non-operative management" @default.
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