Indications For Local Resection Research Articles

Surgical treatment for gastrointestinal neuroendocrine tumors.

Neuroendocrine tumors (NETs) are rare neoplasms, with an estimated annual incidence of 6.9/100 000. They arise from cells of the diffuse endocrine system, which are mainly dispersed throughout the gastrointestinal (GI), pancreatic, and respiratory tracts. The incidence of GI‐NETs has recently begun to show a steady increase. According to the Surveillance, Epidemiology, and End Results database, 53% of patients with NETs present with localized disease, 20% with locoregional disease, and 27% with distant metastases at the time of diagnosis. Surgery is the mainstay for the treatment of locoregional GI‐NETs. Endoscopic resection is an option for well‐differentiated early GI‐NETs, which are thought to very rarely metastasize to lymph nodes. A lesion that is technically difficult to resect via endoscopy is an indication for local resection (partial resection without lymph node dissection). GI‐NETs with possible lymph node metastasis is an indication for enterectomy with lymph node dissection. For NETs with metastatic lesions, cytoreduction surgery can control hormonal hypersecretion and alleviate symptoms; therefore, cytoreduction surgery is recommended. The indications for surgery vary and are based on the organ where the NET arose; therefore, an understanding of the patient's clinical state and individualized treatment that is based on the characteristics of the patient's GI‐NET is needed. This review summarizes surgical treatments of GI‐NETs in each organ.

Indications for local resection for gastric leiomyosarcoma

Indications for local resection for gastric leiomyosarcoma

Carcinoma in situ of the colon.

A case of multicentric neoplasia of the colon is described. At least two of the lesions fit all the criteria for nonpolypoid carcinomain situ, a lesion previously not described in that location. The lesions are believed to have been potentially malignant, but at the time of excision probably were benign. The incidental discovery of nonpolypoid carcinomain situ of the colon should be an indication for local resection and careful search for additional bowel tumors.