Clinical characteristics, risk factors and outcomes of asymptomatic rectal neuroendocrine tumors

Ko, Sun-Hye; Baeg, Myong Ki; Ko, Seung Yeon; Jung, Hae-Ok

doi:10.1007/s00464-016-5413-9

Cited by 8 publications

(4 citation statements)

References 25 publications

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“…When they are symptomatic, rectal NETs may occur with diarrhea, abdominal pain, weight loss, or gastrointestinal blood loss [ 5 ]; severe anemia, hepatomegaly, or abdominal palpable mass can be associated with metastatic disease [ 8 ]. Various clinical data, such as hypertriglyceridemia, low high-density lipoprotein cholesterol levels, higher levels of serum cholesterol, and the presence of metabolic syndrome, have been associated with an increased risk of developing rectal NETs, as reported in the literature; NETs have also been associated with hereditary neuroendocrine syndromes, like von Hippel Lindau syndrome, neurofibromatosis type 1, multiple endocrine neoplasia type 1, and tuberous sclerosis [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

Diagnosis and Management of Rectal Neuroendocrine Tumors (NETs)

et al. 2021

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Rectal neuroendocrine tumors (NETs) are rare, with an incidence of 0.17%, but they represent 12% to 27% of all NETs and 20% of gastrointestinal NETs. Although rectal NETs are uncommon tumors, their incidence has increased over the past few years, and this is probably due to the improvement in detection rates made by advanced endoscopic procedures. The biological behavior of rectal NETs may be different: factors predicting the risk of metastases have been identified, such as size and grade of differentiation. The tendency for metastatic diffusion generally depends on the tumor size, muscular and lymphovascular infiltration, and histopathological differentiation. According to the current European Neuroendocrine Tumor Society (ENETS) guidelines, tumors that are smaller than 10 mm and well differentiated are thought to have a low risk of lymphovascular invasion, and they should be completely removed endoscopically. Rectal NETs larger than 20 mm have a higher risk of involvement of muscularis propria and high metastatic risk and are candidates for surgical resection. There is controversy over rectal NETs of intermediate size, 10–19 mm, where the metastatic risk is considered to be 10–15%: assessment of tumors endoscopically and by endoanal ultrasound should guide treatment in these cases towards endoscopic, transanal, or surgical resection.

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Section: Introductionmentioning

confidence: 99%

Diagnosis and Management of Rectal Neuroendocrine Tumors (NETs)

et al. 2021

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“…4 NENs are divided into two categories according to the clinical symptoms and levels of hormone secretion: functional and non-functional. 5 Over the past 15 years, the incidence of NENs has increased each year, although this may be due to the availability of improved diagnostic techniques; it further demonstrates that the incidence continues to rise. 6 NENs can occur in all age groups, but they are rare in children and young people.…”

Section: Introductionmentioning

confidence: 99%

Progress in the treatment of esophageal neuroendocrine carcinoma

Cai

Cui

2017

Tumour Biol.

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Esophageal neuroendocrine neoplasms are rare. With the improvement and popularization of diagnostic methods, the morbidity statistics have increased annually in recent years. There are currently no treatment guidelines for esophageal neuroendocrine neoplasms, and surgery is the only cure. This usually involves radical surgery when the tumor is limited to the primary site or when only regional lymph node metastasis occurs. Surgical treatment is key to treating esophageal neuroendocrine neoplasms, but combined treatment with chemotherapy and radiotherapy can significantly improve patient survival. The effect of radiotherapy alone on this disease is poor. However, targeted endocrine therapy can improve endocrine hormone symptoms. The prognosis of patients with esophageal neuroendocrine neoplasms is mainly determined by the pathological stage. With the development of molecular biology techniques, the combination of targeted drugs and traditional chemotherapy is expected to provide novel ideas and directions for the treatment of esophageal neuroendocrine neoplasms in the coming years. In this article, the status of esophageal neuroendocrine tumor treatments was reviewed in detail.

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“…The differences in tumor grade, size, invasion depth, and lymphatic vascular invasion can directly influence the prognosis of patients and represent a growing challenge among clinicians. According to Ko et al (19), the risk of developing rectal NETs is 1.5 times more likely to occur in males as opposed to females, and the age of onset ranges from 37 to 57 years old. In the present study, the incidence of rectal NETs was significantly higher in males than in females and highest in middle-aged and elderly patients, which was consistent with Ko et al's findings.…”

Section: Discussionmentioning

confidence: 99%

Prognosis of rectal neuroendocrine tumors after endoscopic resection: a single-center retrospective study

Zheng¹,

Guo²,

Zeng³

et al. 2021

J Gastrointest Oncol

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Background: The efficacy of endoscopic resection in patients with rectal neuroendocrine tumors (NETs) which are less than 20 mm in diameter remains unclear. This study aimed to investigate the efficacy and outcomes of different types of endoscopic resection in patients with NETs.Methods: We performed a retrospective analysis and follow-up on 98 patients who underwent endoscopic resection for rectal NETs between August 2010 and October 2019 at Guangdong Provincial People's Hospital, China. The lesions were preoperatively classified according to their endoscopic morphology and measured by endoscopic ultrasound. Patients were divided into modified endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD) groups depending on the endoscopic treatment they received.The en bloc resection rate, histopathological complete resection rate, and the complication rate of the 2 groups were evaluated after the operation. The risk factors for incomplete resection were also analyzed. Results:The average diameter of the 98 NETs was 6.29±2.90 mm (range, 2-15 mm). The en bloc resection rate of the modified EMR and ESD treatment groups was 97.2% (35/36) and 100% (62/62), respectively. The histopathological complete resection rate was 86.1% (31/36) and 87.1% (54/62), respectively. No tumor recurrence or tumor-related death occurred. There were no statistically significant differences in the rate of histopathological complete resection, perforation, or delayed hemorrhage between the 2 groups (P>0.05).Multivariate analysis demonstrated that the depth of tumor invasion (P=0.007) and tumor diameter (P<0.001) were independent risk factors for histopathological complete resection.Conclusions: Modified EMR and ESD are safe and effective endoscopic approaches for the resection of rectal NETs ≤15 mm in diameter. Endoscopic resection requires a comprehensive preoperative evaluation of risk factors including the depth of tumor invasion and tumor diameter.

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Clinical characteristics, risk factors and outcomes of asymptomatic rectal neuroendocrine tumors

Abstract: Younger age, previous history of malignancy, higher fasting plasma glucose levels and hypertriglyceridemia are significantly associated with rectal NET risk.

Cited by 8 publications

References 25 publications

Diagnosis and Management of Rectal Neuroendocrine Tumors (NETs)

Diagnosis and Management of Rectal Neuroendocrine Tumors (NETs)

Progress in the treatment of esophageal neuroendocrine carcinoma

Prognosis of rectal neuroendocrine tumors after endoscopic resection: a single-center retrospective study

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