| Theme |
Advancement in Diagnosis and Treatment for Duodenal Neoplasms |
| Title |
Therapeutic Strategy for Nonampullary Duodenal Epithelial Tumors Treatment |
| Author |
Noboru Kawata |
Division of Endoscopy, Shizuoka Cancer Center |
| Author |
Hiroyuki Ono |
Division of Endoscopy, Shizuoka Cancer Center |
| Author |
Naomi Kakushima |
Division of Endoscopy, Shizuoka Cancer Center |
| Author |
Masaki Tanaka |
Division of Endoscopy, Shizuoka Cancer Center |
| Author |
Kohei Takizawa |
Division of Endoscopy, Shizuoka Cancer Center |
| Author |
Hideyuki Kanemoto |
Division of Hepato-Biliary-Pancreatic Surgery, Shizuoka Cancer Center |
| [ Summary ] |
Nonampullary duodenal epithelial tumors are rare tumors. No consensus has been reached regarding endoscopic diagnosis, predictive factors for lymph node metastasis, or therapeutic strategy. By examining treatment outcomes at our institution, the optimum therapeutic strategy for duodenal adenomas, duodenal cancer, and carcinoid tumors was investigated. Low-grade adenomas receive routine follow-ups because endoscopic treatment in the duodenum is technically difficult. Endoscopic treatment is indicated for high-grade adenomas and mucosal cancer. However, surgery should also be considered if the location or size of the tumor makes endoscopic treatment technically difficult. Surgery with lymph node dissection is indicated for submucosal cancers because there is a risk of lymph node metastasis. At our institution, surgery is considered to be the first-line treatment for duodenal carcinoid tumors. This is because in the present study, lymph node metastasis was observed in a lesion size ≤10 mm, NET G1 and invasion depth was in the submucosal layer without lymphovascular invasion. |