INTRODUCTION The characteristics, prognostic factors, and management of duodenal neuroendocrine neoplasms (dNEN) are ill-defined, given their rarity. Whether nonsurgical management might be appropriate for patients with nonmetastatic dNEN and a good prognosis, as is the case for pancreatic NEN (pNEN), is unknown. We aimed to describe the management and prognosis of nonmetastatic dNEN patients. METHODS All consecutive patients with nonmetastatic dNEN managed between 1981 and 2018 in 2 expert centers were included. Recurrence-free survival (RFS) and factors associated with recurrence were estimated. RESULTS A total of 145 patients with dNEN were included. Twenty-eight patients with sporadic, nonfunctioning, small (median 7 mm) dNEN underwent endoscopic resection, with a 5-year RFS rate of 89.4%. Local recurrence occurred in 2 patients, who underwent surgery with no new events. The 5-year RFS rate was 87.9% in patients who underwent surgery. Upon univariate analysis, age, size, Ki67 index, and lymph node involvement (LN+) were significantly associated with worse RFS for all dNEN treated (endoscopy/surgery); multivariate analysis found that age, size, and LN+ were associated with worse RFS. CONCLUSION Selected nonmetastatic dNEN had a favorable outcome, and a less invasive therapeutic strategy appeared more suitable than oncological surgery.

中文翻译：

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局部十二指肠神经内分泌肿瘤的治疗和预后。

引言 十二指肠神经内分泌肿瘤 (dNEN) 的特征、预后因素和管理不明确，因为它们很罕见。非手术治疗是否适合非转移性 dNEN 和良好预后的患者，如胰腺 NEN (pNEN) 的情况，尚不清楚。我们旨在描述非转移性 dNEN 患者的治疗和预后。方法 纳入 1981 年至 2018 年间在 2 个专家中心管理的所有非转移性 dNEN 连续患者。估计无复发生存期（RFS）和与复发相关的因素。结果共纳入 145 名 dNEN 患者。28 例散发性、无功能、小（中位数 7 mm）dNEN 患者接受了内镜下切除术，5 年 RFS 率为 89.4%。2例局部复发，谁接受了手术，没有新的事件。接受手术的患者的 5 年 RFS 率为 87.9%。在单变量分析中，年龄、大小、Ki67 指数和淋巴结受累 (LN+) 与所有 dNEN 治疗（内窥镜检查/手术）的较差 RFS 显着相关；多变量分析发现，年龄、大小和 LN+ 与较差的 RFS 相关。结论 选定的非转移性 dNEN 具有良好的结果，并且侵入性较小的治疗策略似乎比肿瘤手术更合适。和 LN+ 与较差的 RFS 相关。结论 选定的非转移性 dNEN 具有良好的结果，并且侵入性较小的治疗策略似乎比肿瘤手术更合适。和 LN+ 与较差的 RFS 相关。结论 选定的非转移性 dNEN 具有良好的结果，并且侵入性较小的治疗策略似乎比肿瘤手术更合适。