{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T05:39:25Z","timestamp":1783575565874,"version":"3.55.0"},"reference-count":29,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2021,5,28]],"date-time":"2021-05-28T00:00:00Z","timestamp":1622160000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"<jats:p>Guidelines have differed in their opinion regarding the indications for endoscopic resection of gastric-neuroendocrine neoplasms (g-NENs) and duodenal-NENs (d-NENs). We examined the association between size and lymph node metastasis (LNM) to identify candidates most suitable for endoscopic resection. We identified 706 patients with T1\/T2 g-NENs and 621 patients with T1\/T2 d-NENs from the SEER database. The prevalence of LNM and risk factors associated with LNM were analyzed. LNM was present in 8.1% of patients with gastroduodenal neuroendocrine tumors (NETs) and 31.6% of patients with neuroendocrine carcinomas (NECs). Multivariate logistic regression indicated that tumor size &amp;gt;10mm, greater invasion depth, and poor differentiation were independently associated with LNM. In addition, the percentage of g-NETs invading submucosa with LNM increased with tumor size (\u226410 mm,3.9%;11\u201320 mm,8.6%;&amp;gt;20\u00a0mm,16.1%). However, in contrast to the low LNM risk in patients with small g-NETs (\u226410 mm), we found that LNM rate exceeded 5% even for patients with small submucosal-infiltrating d-NETs. Among patients with nodal-negative g-NETs, the cause specific survival (CSS) was similar for those who received surgical resection and endoscopic resection. Among patients with d-NETs, the CSS was better for those who received endoscopic resection. In conclusion, patients with d-NETs had a higher probability of LNM than those with g-NETs. Endoscopic resection can be utilized for curative treatment of submucosa-infiltrating g-NETs and intramucosal d-NETs when the size is 10\u00a0mm or less. These results reinforce the need to search for LNM in lesions that are larger than 10\u00a0mm.<\/jats:p>","DOI":"10.3389\/fendo.2021.658392","type":"journal-article","created":{"date-parts":[[2021,5,28]],"date-time":"2021-05-28T11:15:33Z","timestamp":1622200533000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":8,"title":["Patterns of Lymph Node Metastasis in Patients With T1\/T2 Gastroduodenal Neuroendocrine Neoplasms: Implications for Endoscopic Treatment"],"prefix":"10.3389","volume":"12","author":[{"given":"Yu-Jie","family":"Zhou","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qi-Wen","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qing-Wei","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jin-Nan","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xin-Yuan","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yun-Jie","family":"Gao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiao-Bo","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2021,5,28]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1530\/ERC-12-0024","article-title":"Neuroendocrine Tumor Disease: An Evolving Landscape","volume":"19","author":"Frilling","year":"2012","journal-title":"Endocr Relat Cancer"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21493","article-title":"Gastroenteropancreatic Neuroendocrine Tumors","volume":"68","author":"Cives","year":"2018","journal-title":"CA Cancer J Clin"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoncol.2017.0589","article-title":"Trends in the Incidence, Prevalence, and Survival Outcomes in Patients With Neuroendocrine Tumors in the United States","volume":"3","author":"Dasari","year":"2017","journal-title":"JAMA Oncol"},{"key":"B4","doi-asserted-by":"publisher","first-page":"39","DOI":"10.1186\/s12902-017-0190-6","article-title":"Clinicopathological Features and Prognosis of Gastroenteropancreatic Neuroendocrine Neoplasms in a Chinese Population: A Large, Retrospective Single-Centre Study","volume":"17","author":"Zhang","year":"2017","journal-title":"BMC Endocr Disord"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1097\/MPA.0b013e3181ebb168","article-title":"NANETS Treatment Guidelines: Well-Differentiated Neuroendocrine Tumors of the Stomach and Pancreas","volume":"39","author":"Kulke","year":"2010","journal-title":"Pancreas"},{"key":"B6","doi-asserted-by":"publisher","first-page":"74","DOI":"10.1159\/000335595","article-title":"Enets Consensus Guidelines for the Management of Patients With Gastroduodenal Neoplasms","volume":"95","author":"Delle Fave","year":"2012","journal-title":"Neuroendocrinology"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1159\/000443168","article-title":"Enets Consensus Guidelines Update for Gastroduodenal Neuroendocrine Neoplasms","volume":"103","author":"Delle Fave","year":"2016","journal-title":"Neuroendocrinology"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.5603\/EP.2017.0016","article-title":"Gastroduodenal Neuroendocrine Neoplasms, Including Gastrinoma - Management Guidelines (Recommended by the Polish Network of Neuroendocrine Tumours)","volume":"68","author":"Lipinski","year":"2017","journal-title":"Endokrynol Pol"},{"key":"B9","unstructured":"National Comprehensive Cancer Network. 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