title: Endoscopic resection for duodenal carcinoid tumors: a multicenter, retrospective study.
abstract: OBJECTIVE
  Gastrointestinal carcinoid tumors < 10 mm in diameter and limited to the submucosal layer demonstrate a low frequency of lymph node and distant metastasis, and are suitable for endoscopic treatment. The aim of this study was to assess the efficacy, safety, and long-term prognosis of endoscopic resections for the treatment of duodenal carcinoid tumors.
  
  
  METHODS
  This study included a total of 41 duodenal carcinoid tumors in 38 patients between January 2006 and December 2011. The indications for endoscopic resection were lesions ≤ 10 mm in diameter, confined to the submucosal layer, and without lymph node or distant metastasis. Endoscopic resection was accomplished using endoscopic mucosal resection (EMR), EMR with a ligation device (EMR-L), EMR after circumferential precutting, or endoscopic submucosal dissection (ESD).
  
  
  RESULTS
  EMR was performed in 18 tumors, EMR-L in 16, EMR after circumferential precutting in 3, and ESD in 4. En-bloc resection was performed in 39 tumors (95%), and endoscopic complete resection was achieved in 40 (98%); pathological complete resection was achieved in 17 tumors (41%). The endoscopic complete resection rate did not differ according to the resection method, but the pathological complete resection rate was higher for ESD than for EMR and EMR-L. Intraprocedural bleeding was noted in five cases, with no occurrence of perforation. Recurrence was not observed during the mean follow-up period of 17 months (range 1-53 months).
  
  
  CONCLUSIONS
  Endoscopic resection appears to be a safe and effective treatment for duodenal carcinoid tumors measuring ≤ 10 mm in diameter and confined to the submucosal layer.
authors.affiliation: Department of Internal Medicine, Pusan National University School of Medicine and Biomedical Research Institute, Pusan National University Hospital, Busan, Korea.
authors.forename: Gwang Ha
authors.initials: GH
authors.lastname: Kim
authors.forename: Jin Il
authors.initials: JI
authors.lastname: Kim
authors.forename: Seong Woo
authors.initials: SW
authors.lastname: Jeon
authors.forename: Jeong Seop
authors.initials: JS
authors.lastname: Moon
authors.forename: Il-Kwun
authors.initials: IK
authors.lastname: Chung
authors.forename: Sam-Ryong
authors.initials: SR
authors.lastname: Jee
authors.forename: Heung Up
authors.initials: HU
authors.lastname: Kim
authors.forename: Geom Seog
authors.initials: GS
authors.lastname: Seo
authors.forename: Gwang Ho
authors.initials: GH
authors.lastname: Baik
authors.forename: Yong Chan
authors.initials: YC
authors.lastname: Lee
mesh_terms: D000328:Adult; D000368:Aged; D002276:Carcinoid Tumor / Q000473:pathology / Q000601:surgery*; D004379:Duodenal Neoplasms / Q000601:surgery*; D004384:Duodenoscopy / Q000295:instrumentation / Q000379:methods*; D004386:Duodenum / Q000473:pathology / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007413:Intestinal Mucosa / Q000473:pathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D015337:Multicenter Studies as Topic; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome
keywords: carcinoid tumor; duodenum; endoscopic resection