Long-term follow up of endoscopic resection for type 3 gastric NET

AIM:To clarify the short and long-term results and to prove the usefulness of endoscopic resection in type 3gastric neuroendocrine tumors(NETs).METHODS:Of the 119 type 3 gastric NETs diagnosed from January 1996 to September 2011,50 patients treated with endoscopic resection were enrolled in this study.For endoscopic resection,endoscopic mucosal resection(EMR)or endoscopic submucosal dissection(ESD)was used.Therapeutic efficacy,complications,and follow-up results were evaluated retrospectively.RESULTS:EMR was performed in 41 cases and ESD in 9 cases.Pathologically complete resection was performed in 40 cases(80.0%)and incomplete resection specimens were observed in 10 cases(7 vs 3 patients in the EMR vs ESD group,P=0.249).Upon analysis of the incomplete resection group,lateral or vertical margin invasion was found in six cases(14.6%)in the EMR group and in one case in the ESD group(11.1%).Lymphovascular invasions were observed in two cases(22.2%)in the ESD group and in one case(2.4%)in the EMR group(P=0.080).During the follow-up period(43.73;13-60 mo),there was no evidence of tumor recurrence in either the pathologically complete resection group or the incomplete resection group.No recurrence was reported during follow-up.In addition,no mortality was reported in either the complete resection group or the incomplete resection group for the duration of the follow-up period.CONCLUSION:Less than 2 cm sized confined submucosal layer type 3 gastric NET with no evidence of lymphovascular invasion,endoscopic treatment could be considered at initial treatment.