Published online Dec 15, 2020. doi: 10.4251/wjgo.v12.i12.1416
Peer-review started: July 11, 2020
First decision: September 17, 2020
Revised: September 28, 2020
Accepted: October 28, 2020
Article in press: October 28, 2020
Published online: December 15, 2020
Processing time: 152 Days and 9.3 Hours
For the rarity of type 3 gastric neuroendocrine tumours (g-NETs), their clinicopathological characteristics and prognosis are not well illustrated.
To describe the clinicopathological features and outcome of type 3 g-NETs in the Chinese population.
Based on the 2019 WHO pathological classification, the clinicopathological characteristics and prognosis of patients with type 3 g-NETs in China were retrospectively analysed.
A total of 77 patients (55.8% of females) with type 3 g-NETs were analysed, with a median age of 48 years (range: 28-79 years). The tumours were mainly located in the gastric fundus/body (83.1%) and were mostly solitary (83.1%), with a median size of 1.5 cm (0.8-3.5 cm). Of these, there were 37 G1 tumours (48.1%), 31 G2 (40.3%), and 9 G3 (11.7%). Ten (13.0%) and 24 (31.2%) patients had lymph node and distant metastasis, respectively. In addition, type 3 g-NETs were heterogeneous. Compared with G1 NETs, G2 NETs had a higher lymph node metastasis rate, and G3 NETs had a higher distant metastasis rate. G1 and G2 NETs with stage I/II disease (33/68) received endoscopic treatment, and no tumour recurrence or tumour-related death was observed within a median follow-up time of 36 mo. Grade and distant metastasis were identified to be independent risk factors for prognosis in multivariable analysis.
Type 3 g-NETs are obviously heterogeneous, and the updated WHO 2019 pathological classification may be used to effectively evaluate their biological behaviors and prognosis. Also, endoscopic treatment should be considered for small (< 2 cm), low grade, superficial tumours.
Core Tip: Type 3 gastric neuroendocrine tumours (g-NETs) were heterogeneous based on the 2019 WHO pathological classification. Endoscopic treatment was safe and effective for patients with G1 NETs having tumours under 2 cm, confined to the mucosa or submucosa. The prognosis of type 3 g-NETs was related to stage and grade, which were its independent prognostic factors, and the 2019 WHO pathological classification was effective to predict the biological behaviors and prognosis of type 3 g-NETs.