Surgical planning of small intestine neuroendocrine tumors: the concept of mesenteric tumor deposits
The mesenteric extension of small neuroendocrine tumors is the surgical limiting factor because of the risk of postoperative short bowel syndrome due to superior mesenteric artery involvement. Recent pathological studies have shown that this vascular involvement is due to mesenteric tumor deposits,...
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Bioscientifica
2025-02-01
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| Series: | Endocrine Oncology |
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| Online Access: | https://eo.bioscientifica.com/view/journals/eo/5/1/EO-24-0056.xml |
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| author | Romain L’Huillier Gilles Poncet Arnaud Pasquer Thomas Walter Catherine Lombard-Bohas Valérie Hervieu Bénédicte Cayot Pierre-Jean Valette Helen Cheung Laurent Milot |
| author_facet | Romain L’Huillier Gilles Poncet Arnaud Pasquer Thomas Walter Catherine Lombard-Bohas Valérie Hervieu Bénédicte Cayot Pierre-Jean Valette Helen Cheung Laurent Milot |
| author_sort | Romain L’Huillier |
| collection | DOAJ |
| description | The mesenteric extension of small neuroendocrine tumors is the surgical limiting factor because of the risk of postoperative short bowel syndrome due to superior mesenteric artery involvement. Recent pathological studies have shown that this vascular involvement is due to mesenteric tumor deposits, differentiated from lymph node metastases. The aim of this study was to evaluate the performances of computed tomography (CT) for the surgical planning of small intestine neuroendocrine tumors. This was a retrospective observational study, and all patients undergoing surgery for small intestine neuroendocrine tumor between January 2014 and March 2019 were included. Preoperative CTs were reviewed, blinded from surgical and pathological data, by two radiologists. Diagnostic accuracy and interobserver reliability analysis were performed. We included 45 patients (mean age: 61 years (28–84 years); 23 men). The CT sensitivity to identify the mesenteric mass was 97% (37/38) with a ĸ of 0.73. The positive predictive value of CT to anticipate a right colic resection was 86% (18/21). The negative predictive value of CT was high (97% (34/35) to 100% (35/35)) for duodenal resection (ĸ = 0.78). Regarding retropancreatic lymph node invasion, the CT sensitivity was poor (24%, 4/17), with a high ĸ (0.88). The level of involvement by the mesenteric mass was correlated with the length and the percentage of the remaining small bowel. CT is essential for the surgical planning of small intestine neuroendocrine tumors, being accurate in defining the mesenteric tumor deposits, allowing one to anticipate, with a good reproducibility, the length and percentage of the remaining small bowel and the necessity for a right colectomy. |
| format | Article |
| id | doaj-art-73c09b39b8544765a263070993147b94 |
| institution | Kabale University |
| issn | 2634-4793 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | Bioscientifica |
| record_format | Article |
| series | Endocrine Oncology |
| spelling | doaj-art-73c09b39b8544765a263070993147b942025-02-09T12:00:09ZengBioscientificaEndocrine Oncology2634-47932025-02-015110.1530/EO-24-00561Surgical planning of small intestine neuroendocrine tumors: the concept of mesenteric tumor depositsRomain L’Huillier0Gilles Poncet1Arnaud Pasquer2Thomas Walter3Catherine Lombard-Bohas4Valérie Hervieu5Bénédicte Cayot6Pierre-Jean Valette7Helen Cheung8Laurent Milot9Department of Radiology, Hôpital Edouard Herriot, University Hospital of Lyon, Lyon, FranceDepartment of Digestive Surgery, Hôpital Edouard Herriot, University Hospital of Lyon, Lyon, FranceDepartment of Digestive Surgery, Hôpital Edouard Herriot, University Hospital of Lyon, Lyon, FranceDepartment of Gastroenterology and Medical Oncology, Hôpital Edouard Herriot, University Hospital of Lyon, Lyon, FranceDepartment of Gastroenterology and Medical Oncology, Hôpital Edouard Herriot, University Hospital of Lyon, Lyon, FranceDepartment of Pathology, Hôpitaux Est, University Hospital of Lyon, Lyon, FranceDepartment of Radiology, Hôpital Edouard Herriot, University Hospital of Lyon, Lyon, FranceDepartment of Radiology, Hôpital Edouard Herriot, University Hospital of Lyon, Lyon, FranceDepartment of Medical Imaging, Sunnybrook Health Sciences Centre, Toronto, CanadaDepartment of Radiology, Hôpital Edouard Herriot, University Hospital of Lyon, Lyon, FranceThe mesenteric extension of small neuroendocrine tumors is the surgical limiting factor because of the risk of postoperative short bowel syndrome due to superior mesenteric artery involvement. Recent pathological studies have shown that this vascular involvement is due to mesenteric tumor deposits, differentiated from lymph node metastases. The aim of this study was to evaluate the performances of computed tomography (CT) for the surgical planning of small intestine neuroendocrine tumors. This was a retrospective observational study, and all patients undergoing surgery for small intestine neuroendocrine tumor between January 2014 and March 2019 were included. Preoperative CTs were reviewed, blinded from surgical and pathological data, by two radiologists. Diagnostic accuracy and interobserver reliability analysis were performed. We included 45 patients (mean age: 61 years (28–84 years); 23 men). The CT sensitivity to identify the mesenteric mass was 97% (37/38) with a ĸ of 0.73. The positive predictive value of CT to anticipate a right colic resection was 86% (18/21). The negative predictive value of CT was high (97% (34/35) to 100% (35/35)) for duodenal resection (ĸ = 0.78). Regarding retropancreatic lymph node invasion, the CT sensitivity was poor (24%, 4/17), with a high ĸ (0.88). The level of involvement by the mesenteric mass was correlated with the length and the percentage of the remaining small bowel. CT is essential for the surgical planning of small intestine neuroendocrine tumors, being accurate in defining the mesenteric tumor deposits, allowing one to anticipate, with a good reproducibility, the length and percentage of the remaining small bowel and the necessity for a right colectomy.https://eo.bioscientifica.com/view/journals/eo/5/1/EO-24-0056.xmlneuroendocrinesmall bowelsmall intestinecomputed tomographymesenteric tumor depositssurgical planninglymph nodesmesenteric massshort small bowel syndrome |
| spellingShingle | Romain L’Huillier Gilles Poncet Arnaud Pasquer Thomas Walter Catherine Lombard-Bohas Valérie Hervieu Bénédicte Cayot Pierre-Jean Valette Helen Cheung Laurent Milot Surgical planning of small intestine neuroendocrine tumors: the concept of mesenteric tumor deposits Endocrine Oncology neuroendocrine small bowel small intestine computed tomography mesenteric tumor deposits surgical planning lymph nodes mesenteric mass short small bowel syndrome |
| title | Surgical planning of small intestine neuroendocrine tumors: the concept of mesenteric tumor deposits |
| title_full | Surgical planning of small intestine neuroendocrine tumors: the concept of mesenteric tumor deposits |
| title_fullStr | Surgical planning of small intestine neuroendocrine tumors: the concept of mesenteric tumor deposits |
| title_full_unstemmed | Surgical planning of small intestine neuroendocrine tumors: the concept of mesenteric tumor deposits |
| title_short | Surgical planning of small intestine neuroendocrine tumors: the concept of mesenteric tumor deposits |
| title_sort | surgical planning of small intestine neuroendocrine tumors the concept of mesenteric tumor deposits |
| topic | neuroendocrine small bowel small intestine computed tomography mesenteric tumor deposits surgical planning lymph nodes mesenteric mass short small bowel syndrome |
| url | https://eo.bioscientifica.com/view/journals/eo/5/1/EO-24-0056.xml |
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