このエントリーをはてなブックマークに追加
ID 62756
フルテキストURL
著者
Kanzaki, Hiromitsu Department of Gastroenterology and Hepatology, Okayama University Hospital ORCID publons researchmap
Matsueda, Kazuhiro Department of Gastroenterology and Hepatology, Kurashiki Central Hospital
Nakagawa, Masahiro Department of Endoscopy, Hiroshima City Hiroshima Citizens Hospital
Inaba, Tomoki Department of Gastroenterology, Kagawa Prefectural Central Hospital
Takatani, Masahiro Department of Internal Medicine, Japanese Red Cross Society Himeji Hospital
Takenaka, Ryuta Department of Internal Medicine, Tsuyama Chuo Hospital
Yoshioka, Masao Department of Internal Medicine, Okayama Saiseikai General Hospital
Imagawa, Atsushi Department of Gastroenterology, Mitoyo General Hospital
Inoue, Masafumi Department of Gastroenterology, Japanese Red Cross Okayama Hospital
Suzuki, Seiyuu Department of Internal Medicine, Sumitomo Besshi Hospital
Tomoda, Jun Department of Internal Medicine, Akaiwa Medical Association Hospital
Iwamuro, Masaya Department of Gastroenterology and Hepatology, Okayama University Hospital ORCID Kaken ID publons researchmap
Kawano, Seiji Department of Gastroenterology and Hepatology, Okayama University Hospital ORCID
Kawahara, Yoshiro Department of Gastroenterology, Japanese Red Cross Okayama Hospital
Tanaka, Takehiro Department of Pathology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences ORCID Kaken ID publons
Okada, Hiroyuki Department of Gastroenterology and Hepatology, Okayama University Hospital Kaken ID publons researchmap
抄録
Sporadic non-ampullary duodenal adenoma (SNADA) is a rare disease, and therefore, its clinical characteristics have not been comprehensively investigated. Furthermore, owing to the high complication rates and severity of endoscopic resection, treatment strategies vary among facilities. In the present study, we aimed to clarify the clinical characteristics and course of SNADA. We extracted clinical and histological records of SNADA cases diagnosed in 11 hospitals between September 1999 and August 2014. The patients were divided into "no-resection" and "resection" groups based on the initial treatment approach. We investigated the long-term outcome of the "no-resection" group and treatment results of the "resection" group, with particular interest in endoscopic resection. Overall, 299 patients were diagnosed with SNADA. The median age at diagnosis was 67 years (range, 31-88 years), with approximately twice as many men as women. The median tumor size was 8.0 mm (2-60 mm). In total, 161 patients were initially selected for no-resection and 138 underwent resection. Age >70 years and the presence of either severe illness or poor performance status were significantly related to opting for no-resection. In the no-resection group, 101 patients underwent endoscopic follow-up for at least 1 year. During the observational period (2.5 +/- 2.2 years), 27 lesions (27%) disappeared following cold forceps biopsy, and 13 lesions (14%) presented lateral growth. Four lesions (4%) changed to mucosal carcinoma, 3 were treated endoscopically, and 1 was surgically resected. Nineteen patients died; however, no one died of duodenal carcinoma. In the endoscopic resection group, en bloc resection was achieved in 78% of patients. However, the complication rate for perforation was 7%, and endoscopic submucosal dissection was associated with a 36% perforation rate. With the low incidence of cancer development and no disease specific death, the strategy of initially not performing resection could be considered especially for the older adults, poor-prognosis patients, or small lesions.
キーワード
duodenal neoplasms
endoscopic mucosal resection
natural history
発行日
2021-10-01
出版物タイトル
Medicine
100巻
39号
出版者
Lippincott Williams & Wilkins
開始ページ
e27382
ISSN
0025-7974
資料タイプ
学術雑誌論文
言語
英語
OAI-PMH Set
岡山大学
著作権者
© 2021 the Author(s).
論文のバージョン
publisher
PubMed ID
DOI
Web of Science KeyUT
関連URL
isVersionOf https://doi.org/10.1097/MD.0000000000027382
ライセンス
http://creativecommons.org/licenses/by-nc/4.0
Citation
Kanzaki H, Matsueda K, Nakagawa M, Inaba T, Takatani M, Takenaka R, Yoshioka M, Imagawa A, Inoue M, Suzuki S, Tomoda J, Iwamuro M, Kawano S, Kawahara Y, Tanaka T, Okada H. Clinical characteristics and course of sporadic non-ampullary duodenal adenomas: a multicenter retrospective study. Medicine 2021;100:39(e27382).