Clinical and oncological outcomes of gastroduodenal neuroendocrine tumours after endoscopic resection in the Western setting - a target trial emulation.

Authors

Francisco Mendes, Rafael José Vieira, Maria Alípio, Gianluca Esposito, Francesco Panzuto, Elisabetta Dell'Unto, Enrique Rodriguez-Santiago, Alberto Velasco Hernandez, Ignacio Ruz Caracuel, Joana Camões Neves, Aníbal Ferreira, Frederic Moll, Mathieu Pioche, Elisa Gravito Soares, Pedro Amaro, Mariana Souto, Sofia Xavier, José Cotter, Sofia Ponte, Joana Alves Silva, Ricardo Küttner Magalhães, Luís Correia Gomes, Ana Laranjo, Rute Gomes, Caroline Soares, Ricardo Cardoso, Sunil Gupta, Michael Bourke, Nuno Gonçalves, Raquel Ortigão, Diogo Libânio, Alessandro Rimondi, Alberto Murino, Edward J Despott, Georgios Tribonias, Petros Zormpas, Alice Wartski, Jeremie Jacques, Paolo Cecinato, Giovanni Barbara, Romano Sassatelli, Giuliana Sereni, Katrin Marlene Schaffitzel, Stefan Goelder, Giulio Calabrese, Sandro Sferrazza, Ana Craciun, Miguel Moura, Tamas Tornai, David Tate, Georgios Mavrogenis, Benjamin Walter, Hugo Uchima, Hans-Peter Allgaier, Frieder Berr, Joana Frias, Margarida Marques, Irene Gullo, Fátima Carneiro, Dermot O'Toole, João Santos-Antunes, Bernardo Sousa Pinto, Guilherme Macedo, Rui Morais

Published in

Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association. Sep 28, 2026. Epub Sep 28, 2026.

Abstract

Gastroduodenal neuroendocrine tumours (GD-NETs) are increasingly diagnosed. We aimed to (i) evaluate the long-term outcomes following endoscopic resection (ER) of GD-NETs, and (ii) compare the effectiveness of different ER techniques.
We conducted a multinational retrospective study (24 centres, 10 Western countries) of consecutive patients undergoing ER of GD-NETs. The main evaluated outcomes were the frequency of curative resection and residual disease. Additional evaluated outcomes included R0 resection rate and local recurrence. We performed a target-trial emulation to compare endoscopic submucosal dissection (ESD), conventional endoscopic mucosal resection (C-EMR), and modified-EMR for these outcomes, while adjusting for potential cofounders.
We analysed 444 GD-NETs (304 gastric, 140 duodenal) from 434 patients (median follow-up of 36 months). The curative resection rate was 51.6% for gastric NETs and 33.6% for duodenal NETs. The residual disease rate was 19.0% for gastric NETs and 10.8% for duodenal NETs. GD-NET-related mortality was 0.2%. Target-trial emulation demonstrated that ESD, compared with C-EMR, achieved a significantly higher R0 resection (60.9% vs. 45.6%; risk difference=15.3 percent points [pp]) and lower risk of local recurrence at 4 (risk difference=12.0 pp) and 5 years (risk difference=14.3 pp). No significant differences were observed between the three ER approaches for other outcomes.
GD-NETs were associated with frequent non-curative ER resections, but low recurrence and tumour-related mortality. ESD achieved a higher adjusted R0 resection rate and lower local recurrence compared with C-EMR. These results support the refinement of not only the curative resection criteria but also patient and ER technique selection.

PMID:
42805276
Bibliographic data and abstract were imported from PubMed on 29 Sep 2026.

Read full publication at:
Please sign in to see all details.

Stats

1-terrible, 9-excellent. How would you rate this publication? Sign in in to submit your rating.

Post a comment

You need to be signed in to post comments. You can sign in here.

Comments

There are no comments yet.