Endoscopic submucosal dissection for foregut neuroendocrine tumors: An initial study

Table 1 World Health Organization 2010 classification and suggested grading of neuroendocrine neoplasms of the digestive system[20]

Classification	Grading
	Grade	Mitotic count (per 10 HPF)	Ki-67 index (%)
NET	G1	< 2	< 2
NET	G2	2–20	3-20
NEC	G3	> 20	> 20

HPF: High-power field; NEC: Neuroendocrine carcinoma; NET: Neuroendocrine tumor; G1: Low-grade tumors; G2: Intermediate-grade tumors; G3: High-grade tumors.

Table 2 Clinicopathological characteristics of 24 patients with foregut neuroendocrine tumors treated by endoscopic submucosal dissection

Case no.	Age (yr)	Gender	Location	Macroscopic appearance	Clinicopathological type	Size (mm)	en bloc resection	Depth of invasion	WHO classification	Lateral margin	Vertical margin	Vessel invasion	Complication	Additional surgery	Follow-up (mo)
1	41	M	Gastric antrum	Submucosal tumor	III	10	Yes	Submucosa	NET-G1	(-)	(-)	Absent	None	None	48
2	53	M	Gastric body	Submucosal tumor	I	5	Yes	Submucosa	NET-G1	(-)	(-)	Absent	None	None	40
3	71	M	Gastric body	Submucosal tumor	III	18	Yes	Submucosa	NET-G1	(-)	(-)	Absent	None	Reject	36
4	55	F	Gastric body	Submucosal tumor	III	10	Yes	Submucosa	NET-G1	(-)	(-)	Absent	None	None	30
5	82	F	Gastric fundus	Submucosal tumor	III	30	Yes	Submucosa	NET-G2	(-)	(-)	Absent	None	Reject	30
6	35	F	Gastric fundus	Polyp	I	6	Yes	Submucosa	NET-G1	(-)	(-)	Absent	None	None	30
7	35	M	Duodenal bulb	Submucosal tumor	NA	15	Yes	Submucosa	NET-G1	(-)	(-)	Absent	None	Reject	30
8	57	M	Duodenal bulb	Submucosal tumor	NA	5	Yes	Submucosa	NET-G1	(-)	(-)	Absent	None	None	30
9	40	F	Gastric body	Polyp	I	6	Yes	Submucosa	NET-G1	(-)	(-)	Absent	None	None	30
10	47	F	Gastric body	Submucosal tumor	I	4	Yes	Submucosa	NET-G1	(-)	(-)	Absent	None	None	30
11	71	F	Duodenal bulb	Submucosal tumor	NA	6	Yes	Submucosa	NET-G1	(-)	(-)	Absent	None	None	24
12	56	F	Gastric body	Polyp	I	3, 2	Yes	Mucosa	NET-G1	(-)	(-)	Absent	None	None	24
13	51	F	Gastric body	Submucosal tumor	III	8	Yes	Submucosa	NET-G1	(-)	(-)	Absent	None	None	24
14	55	M	Gastric body	Polyp	I	8, 3, 3	Yes	Submucosa	NET-G1	(-)	(-)	Absent	None	None	24
15	55	M	Gastric body	Polyp	I	4	Yes	Submucosa	NET-G1	(-)	(-)	Absent	None	None	18
16	45	F	Esophagus	Submucosal tumor	NA	30	Yes	Muscularis	NEC	(-)	(+)	Present	None	Yes	18
17	57	M	Gastric body	Submucosal tumor	III	15	Yes	Submucosa	NET-G1	(-)	(-)	Absent	Delayed bleeding	Reject	22
18	35	F	Gastric body	Submucosal tumor	III	25	Yes	Submucosa	NET-G2	(-)	(-)	Absent	None	Yes	18
19	70	F	Duodenal bulb	Submucosal tumor	NA	10	Yes	Submucosa	NET-G1	(-)	(-)	Absent	None	None	18
20	45	F	Gastric body	Polyp	I	6, 3	Yes	Submucosa	NET-G1	(-)	(-)	Absent	None	None	12
21	48	F	Gastric body	Polyp	I	5	Yes	Submucosa	NET-G1	(-)	(-)	Absent	None	None	12
22	55	M	Gastric body	Polyp	I	5	Yes	Submucosa	NET-G1	(-)	(-)	Absent	None	None	12
23	65	F	Cardia	Submucosal tumor	III	20	Yes	Submucosa	NET-G1	(-)	(-)	Absent	None	Reject	14
24	35	F	Gastric fundus	Erosion	I	5, 3	Yes	Submucosa	NET-G1	(-)	(-)	Absent	None	None	12

“Reject” means the patient rejected the additional surgery. NA: Not applicable; NEC: Neuroendocrine carcinoma; NET: Neuroendocrine tumor; M: Male; F: Female; WHO: World Health Organization.