{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T20:12:00Z","timestamp":1790971920809,"version":"4.1.0"},"reference-count":32,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2022,9,22]],"date-time":"2022-09-22T00:00:00Z","timestamp":1663804800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Current Oncology"],"abstract":"<jats:p>An increasing number of duodenal tumors are being diagnosed over the years, leading to increased confusion regarding the choice of treatment options. Small-to-large tumors and histological types vary from adenoma to carcinoma, and treatment methods may need to be selected according to lesion characteristics. Because of its anatomic characteristics, complications are more likely to occur in the duodenum than in other gastrointestinal organs. Several reports have described the outcomes of conventional endoscopic mucosal resection, endoscopic submucosal dissection, cold snare polypectomy, underwater endoscopic mucosal resection, endoscopic full-thickness resection, and laparoscopic and endoscopic cooperative surgery for duodenal tumors. However, even in the guidelines set out by various countries, only the treatment methods are listed, and no clear treatment strategies are provided. Although there are few reports with a sufficiently high level of evidence, considering the currently available treatment options is essential. In this report, we reviewed previous reports on each treatment strategy, discussed the current issues and prospects, and proposed the best possible treatment strategy.<\/jats:p>","DOI":"10.3390\/curroncol29100537","type":"journal-article","created":{"date-parts":[[2022,9,22]],"date-time":"2022-09-22T21:10:05Z","timestamp":1663881005000},"page":"6816-6825","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Issues and Prospects of Current Endoscopic Treatment Strategy for Superficial Non-Ampullary Duodenal Epithelial Tumors"],"prefix":"10.3390","volume":"29","author":[{"given":"Tetsuya","family":"Suwa","sequence":"first","affiliation":[{"name":"Division of Endoscopy, Shizuoka Cancer Center, Shizuoka 411-8777, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masao","family":"Yoshida","sequence":"additional","affiliation":[{"name":"Division of Endoscopy, Shizuoka Cancer Center, Shizuoka 411-8777, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroyuki","family":"Ono","sequence":"additional","affiliation":[{"name":"Division of Endoscopy, Shizuoka Cancer Center, Shizuoka 411-8777, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,9,22]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1216","DOI":"10.1111\/jgh.15285","article-title":"The incidence of non-ampullary duodenal cancer in Japan: The first analysis of a national cancer registry","volume":"36","author":"Yoshida","year":"2021","journal-title":"J. Gastroenterol. Hepatol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"773","DOI":"10.1016\/j.gie.2015.06.027","article-title":"The role of endoscopy in ampullary and duodenal adenomas","volume":"82","author":"Chathadi","year":"2015","journal-title":"Gastrointest. Endosc."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"522","DOI":"10.1055\/a-1442-2395","article-title":"Endoscopic management of superficial nonampullary duodenal tumors: European Society of Gastrointestinal Endoscopy (ESGE) Guideline","volume":"53","author":"Vanbiervliet","year":"2021","journal-title":"Endoscopy"},{"key":"ref_4","unstructured":"Japan Duodenal Cancer Guideline Committee (2021). Clinical Practice Guidelines for Duodenal Cancer 2021."},{"key":"ref_5","first-page":"1585","article-title":"Clinical issues of duodenal endoscopic treatment","volume":"51","author":"Ono","year":"2016","journal-title":"Stomach Intest."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"663","DOI":"10.1055\/a-1640-3236","article-title":"Outcomes of endoscopic resection for superficial duodenal tumors: 10 years\u2019 experience in 18 Japanese high volume centers","volume":"54","author":"Kato","year":"2022","journal-title":"Endoscopy"},{"key":"ref_7","first-page":"129","article-title":"Clinical outcome of endoscopic resection for nonampullary duodenal tumors","volume":"47","author":"Nonaka","year":"2015","journal-title":"Endoscopy"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"490","DOI":"10.1080\/00365521.2018.1438508","article-title":"Endoscopic mucosal resection of non-ampullary sporadic duodenal adenomas: A retrospective analysis with long-term follow-up","volume":"53","author":"Valerii","year":"2018","journal-title":"Scand. J. Gastroenterol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"676","DOI":"10.1016\/j.gie.2018.05.002","article-title":"Outcomes of endoscopic resection for superficial duodenal epithelial neoplasia","volume":"88","author":"Yahagi","year":"2018","journal-title":"Gastrointest. Endosc."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1159\/000452363","article-title":"Endoscopic submucosal dissection and endoscopic mucosal resection for non-ampullary superficial duodenal tumor","volume":"95","author":"Hoteya","year":"2017","journal-title":"Digestion"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"15","DOI":"10.5946\/ce.2021.141","article-title":"Current treatment strategy for superficial nonampullary duodenal epithelial tumors","volume":"55","author":"Suwa","year":"2022","journal-title":"Clin. Endosc."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1111\/jgh.15666","article-title":"Long-term outcomes of cold snare polypectomy for superficial non-ampullary duodenal epithelial tumors","volume":"37","author":"Okimoto","year":"2022","journal-title":"J. Gastroenterol. Hepatol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"2918","DOI":"10.1007\/s00464-019-07072-7","article-title":"Local recurrence and its risk factors after cold snare polypectomy of colorectal polyps","volume":"34","author":"Murakami","year":"2020","journal-title":"Surg. Endosc."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1095","DOI":"10.1016\/j.gie.2017.10.041","article-title":"Width and depth of resection for small colorectal polyps: Hot versus cold snare polypectomy","volume":"87","author":"Suzuki","year":"2018","journal-title":"Gastrointest. Endosc."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"E763","DOI":"10.1055\/s-0043-113567","article-title":"A simple endoscopic scoring system to differentiate between duodenal adenoma and carcinoma","volume":"5","author":"Kakushima","year":"2017","journal-title":"Endosc. Int. Open"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1111\/den.12282","article-title":"Diagnostic algorithm of magnifying endoscopy with narrow band imaging for superficial non-ampullary duodenal epithelial tumors","volume":"26","author":"Kikuchi","year":"2014","journal-title":"Dig. Endosc."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"329","DOI":"10.1016\/j.gie.2016.12.007","article-title":"Accuracy of biopsy for the preoperative diagnosis of superficial nonampullary duodenal adenocarcinoma","volume":"86","author":"Kinoshita","year":"2017","journal-title":"Gastrointest. Endosc."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"357","DOI":"10.1038\/ajg.2010.422","article-title":"Sporadic nonampullary duodenal adenoma in the natural history of duodenal cancer: A study of follow-up surveillance","volume":"106","author":"Okada","year":"2011","journal-title":"Am. J. Gastroenterol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"2755","DOI":"10.1007\/s10620-016-4165-7","article-title":"Feasibility of cold snare polypectomy for multiple duodenal adenomas in patients with familial adenomatous polyposis: A pilot study","volume":"61","author":"Hamada","year":"2016","journal-title":"Dig. Dis. Sci."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1010","DOI":"10.1016\/j.cgh.2021.06.043","article-title":"Nonrecurrence Rate of Underwater EMR for \u226420-mm Nonampullary Duodenal Adenomas: A Multicenter Prospective Study (D-UEMR Study)","volume":"20","author":"Yamasaki","year":"2022","journal-title":"Clin. Gastroenterol. Hepatol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"753","DOI":"10.1111\/den.13524","article-title":"Feasibility study comparing underwater endoscopic mucosal resection and conventional endoscopic mucosal resection for superficial non-ampullary duodenal epithelial tumor < 20 mm","volume":"32","author":"Kiguchi","year":"2020","journal-title":"Dig. Endosc."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"565","DOI":"10.1111\/den.13541","article-title":"Feasibility of underwater endoscopic mucosal resection and management of residues for superficial non-ampullary duodenal epithelial neoplasms","volume":"32","author":"Iwagami","year":"2020","journal-title":"Dig. Endosc."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1159\/000484112","article-title":"Current status of endoscopic resection for superficial nonampullary duodenal epithelial tumors","volume":"97","author":"Yamasaki","year":"2018","journal-title":"Digestion"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"3605","DOI":"10.1007\/s00464-018-06644-3","article-title":"Endoscopic full-thickness resection (EFTR) without laparoscopic assistance for nonampullary duodenal subepithelial lesions: Our clinical experience of 32 cases","volume":"33","author":"Ren","year":"2019","journal-title":"Surg. Endosc."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1876","DOI":"10.1007\/s00464-019-07269-w","article-title":"Endoscopic full-thickness resection of duodenal lesions (with video)","volume":"34","author":"Andrisani","year":"2020","journal-title":"Surg. Endosc."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"E659","DOI":"10.1055\/a-1374-6141","article-title":"Endoscopic resection using an over-the-scope clip for duodenal neuroendocrine tumors","volume":"9","author":"Tashima","year":"2021","journal-title":"Endosc. Int. Open."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1729","DOI":"10.1007\/s00464-007-9696-8","article-title":"Laparoscopic and endoscopic cooperative surgery for gastrointestinal stromal tumor dissection","volume":"22","author":"Hiki","year":"2008","journal-title":"Surg. Endosc."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"935","DOI":"10.1007\/s11605-018-3680-6","article-title":"laparoscopic and endoscopic cooperative surgery versus endoscopic submucosal dissection for the treatment of low-risk tumors of the duodenum","volume":"22","author":"Ojima","year":"2018","journal-title":"J. Gastrointest. Surg."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"373","DOI":"10.1111\/den.13705","article-title":"Feasibility of laparoscopic endoscopic cooperative surgery for non-ampullary superficial duodenal neoplasms: Single-arm confirmatory trial","volume":"33","author":"Kanaji","year":"2021","journal-title":"Dig. Endosc."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1065","DOI":"10.1055\/a-1327-5939","article-title":"Safety and feasibility of laparoscopic and endoscopic cooperative surgery for duodenal neoplasm: A retrospective multicenter study","volume":"53","author":"Nunobe","year":"2021","journal-title":"Endoscopy"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1198","DOI":"10.1111\/den.14123","article-title":"Spurting delayed bleeding on postoperative day six after cold snare polypectomy for small superficial duodenal epithelial tumor","volume":"33","author":"Masunaga","year":"2021","journal-title":"Dig. Endosc."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"151","DOI":"10.1111\/den.13570","article-title":"Severe acute pancreatitis following cold polypectomy of the minor duodenal papilla in a case with pancreas divisum","volume":"32","author":"Akimoto","year":"2020","journal-title":"Dig. Endosc."}],"container-title":["Current Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1718-7729\/29\/10\/537\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T00:37:32Z","timestamp":1760143052000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1718-7729\/29\/10\/537"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,9,22]]},"references-count":32,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2022,10]]}},"alternative-id":["curroncol29100537"],"URL":"https:\/\/doi.org\/10.3390\/curroncol29100537","relation":{},"ISSN":["1718-7729"],"issn-type":[{"value":"1718-7729","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,9,22]]}}}