Long-term outcomes of endoscopic resection for non-ampullary duodenal epithelial tumors: A single-center experience

Özet

Background/Aims: The malignant potential of non-ampullary duodenal epithelial tumors (NADETs) is lower compared to that of othergastrointestinal epithelial tumors, but it should not be overlooked. Recently, endoscopic resection (ER) has been proposed as an alternative treatment option for NADETs. Therefore, we aimed to analyze the clinical outcomes of ER of NADETs and determine the factorsassociated with an incomplete resection.Materials and Methods: We conducted a retrospective observational study of 54 patients (56 lesions) with NADETs, who underwent ERin the period between October 2006 and March 2016, and analyzed the therapeutic outcomes and procedure-related adverse events.Results: Endoscopic mucosal resection (EMR) was performed on 41 lesions, and endoscopic submucosal dissection (ESD) was performedon 15 lesions. The en bloc and complete resection rates were 82% (46/56) and 54% (30/56), respectively. Multivariate logistic regressionanalyses determined that the resection method (EMR: odds ratio 4.356, 95% confidence interval 1.021–18.585, p=0.047) was independently associated with incomplete resection. The procedure-related bleeding and perforation rates were 4% and 5%, respectively.Recurrence of tumor occurred in one of 44 patients during the median follow-up period of 25 months (range: 6–89 months).Conclusion: ER is an effective, safe, and feasible treatment option for NADETs. However, the incomplete resection rate increases whenEMR is performed. Nevertheless, given the longer procedure time and the technical difficulty associated with ESD, and the excellentlong-term outcomes associated with EMR, EMR of NADETs is appropriate, especially in patients with dysplastic lesions.