The band and slough technique is effective for management of diminutive type 1 gastric and duodenal neuroendocrine tumors

Abstract

Background and study aims Endoscopic resection is recommended as initial treatment for early-stage gastric and duodenal neuroendocrine tumors (G-NETs and D-NETs). However, it can cause serious adverse events. We aimed to evaluate the efficacy and safety of the band and slough (BAS) technique as a novel and less aggressive endoscopic therapy for management of such tumors.

Four patients, three diagnosed with < 10-mm D-NET and one with 10-mm type I G-NET, were treated with the BAS technique without endoscopic resection. Initial follow-up endoscopy at 3 months was done to assess for residual tumor. Subsequent endoscopic surveillance was performed. After one session of banding, all patients achieved complete remission at 3-month follow-up. No tumor recurrence was detected on repeat biopsy at 12-month surveillance endoscopy. None of the patients developed any adverse events including bleeding or perforation.

The BAS technique may prove to be a safe and effective endoscopic therapy for diminutive, non-metastatic type 1 G-NETs and D-NETs. Studies of larger scale and longer follow-up periods are needed to corroborate these findings.

Publication History

Received: 03 November 2019

Accepted: 03 February 2020

Article published online:
25 May 2020

• References

• 1 Sato Y, Hashimoto S, Mizuno K. et al. Management of gastric and duodenal neuroendocrine tumors. World J Gastroenterol 2016; 22: 6817
• 2 Li TT, Qiu F, Qian ZR. et al. Classification, clinicopathologic features and treatment of gastric neuroendocrine tumors. World J Gastroenterol 2014; 20: 118-1125
• 3 Delle Fave G, Kwekkeboom DJ, Van Custem E. et al. ENETS consensus guidelines for the management of patients with gastroduodenal neoplasms. Neuroendocrinology 2012; 95: 74-87
• 4 Delle Fave G, O'Toole D, Sundin A. et al. ENETS consensus guidelines update for gastroduodenal neuroendocrine neoplasms. Neuroendocr 2016; 103: 119-124
• 5 Kulke MH, Shah MH, Benson AB. et al. Neuroendocrine tumors, version 1. 2015. J Nat Comp Cancer Net 2015; 13: 78-108
• 6 Scherübl H, Cadiot G, Jensen RT. et al. Neuroendocrine tumors of the stomach (gastric carcinoids) are on the rise: small tumors, small problems?. Endoscopy 2010; 42: 664-671
• 7 Raju GS. Complications of endoscopic mucosal resection and endoscopic submucosal dissection. Tech Gastrointest Endosc 2011; 13: 91-94
• 8 Khara HS, Sholvn GJ, Johal AS. et al. Endoscopic banding without resection (BWR) technique for treatment of diminutive neuroendocrine tumors in the duodenum. Endosc Int Open 2019; 7: E302-E307
• 9 Koritala T, Zolotarevsky E, Bartley AN. et al. Efficacy and safety of the band and slough technique for endoscopic therapy of nonampullary duodenal adenomas: a case series. Gastrointest Endosc 2015; 81: 985-988
• 10 Xia FZ, Shen Z, Chen HT. et al. Endoscopic banding ligation can effectively remove the submucosal tumor. Int J Clin Exper Med 2015; 8: 1494