Small-bowel neoplasms in patients undergoing video capsule endoscopy: a multicenter European study

Area of Science:

• Gastroenterology
• Endoscopy
• Oncology

Background:

• Small-bowel tumors are rare, representing 1%-3% of gastrointestinal neoplasms.
• Video capsule endoscopy (VCE) may reveal a higher frequency of these tumors than previously thought.
• VCE is increasingly utilized for diagnosing obscure gastrointestinal issues.

Purpose of the Study:

• To evaluate the frequency of small-bowel tumors in patients undergoing VCE.
• To analyze the clinical presentation, diagnostic work-up, and endoscopic appearance of these tumors.
• To assess the impact of VCE on patient management and treatment.

Main Methods:

• A retrospective analysis of 5129 patients who underwent VCE across 29 centers in 10 European countries.
• Identification of small-bowel tumors based on VCE findings and confirmed by histology.
• Data collection on patient indications, tumor types, diagnostic procedures, and treatment outcomes.

Main Results:

• Small-bowel tumors were identified in 124 patients (2.4%), with 112 primary and 12 metastatic.
• Obscure gastrointestinal bleeding was the primary indication for VCE in 108 patients.
• Gastrointestinal stromal tumors (GIST) were the most common primary type (32%), followed by adenocarcinoma (20%).
• VCE identified 80.6% of tumors, often as the third diagnostic procedure after negative endoscopy.
• Enteroscopy demonstrated a high diagnostic yield in patients undergoing further examination after VCE.
• Surgery was the primary treatment in 95% of cases.

Conclusions:

• VCE detects small-bowel tumors in a small percentage of patients undergoing the procedure.
• Early detection of small-bowel tumors via VCE can significantly shorten the diagnostic process.
• VCE findings influence subsequent patient management and therapeutic strategies for gastrointestinal neoplasms.