Local excision results in comparable survival to radical resection for early-stage rectal carcinoid

Ezekian, Brian; Adam, Mohamad; Turner, Megan C.; Gilmore, Brian F.; Freischlag, Kyle; Leraas, Harold J.; Mantyh, Christopher R.; Migaly, John

doi:10.1016/j.jss.2018.04.038

Cited by 9 publications

(14 citation statements)

References 24 publications

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“…According to different degrees of pathological differentiation, NENs were divided into well‐differentiated NETs, poorly differentiated NETs, and mixed neuroendocrine and/or non‐NETs with both adenocarcinoma and neuroendocrine components 13‐16 . Because of great differences in biological behavior between NET and NEC, the 8th edition of the AJCC staging system focused on NETs, mainly aimed at NET, while NEC staging was based on the criteria of adenocarcinoma at the corresponding site 17‐21 . In this study, we evaluated the survival of NEC patients based on the 8th colorectal cancer staging system, including the analysis of patients with carcinoid tumor NOS and OCT.…”

Section: Discussionmentioning

confidence: 99%

“…[13][14][15][16] Because of great differences in biological behavior between NET and NEC, the 8th edition of the AJCC staging system focused on NETs, mainly aimed at NET, while NEC staging was based on the criteria of adenocarcinoma at the corresponding site. [17][18][19][20][21] In this study, we evaluated the survival of NEC patients based on the 8th colorectal cancer staging system, including the analysis of patients with carcinoid tumor NOS and OCT.…”

Section: Discussionmentioning

confidence: 99%

“…This might be associated with the inherent nature of carcinoid itself. 16,[18][19][20] According to the literature, T status of carcinoid generally needed to consider tumor size and invasive depth, but the 8th edition stage of colorectal cancer did not take into account the parameter of tumor size, although the tumor size was included in the T stage of NET staging system. 22 Tumor size had been proved to be a significant parameter of metastasis in colorectal carcinoids.…”

Section: Discussionmentioning

confidence: 99%

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Prognostic significance for colorectal carcinoid tumors based on the 8th edition TNM staging system

et al. 2020

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The aim of our study was to explore the value of the 8th edition TNM staging system on evaluating the prognosis of colorectal carcinoid. Colorectal carcinoid patients between 1988 and 2015 were selected in the Surveillance, Epidemiology, and End Results Program (SEER) database for analysis. About 4286 patients with colorectal carcinoid tumors were identified, of which were carcinoid tumor NOS (n = 1726), neuroendocrine carcinoma (NEC) (n = 1346) and other carcinoid tumor (OCT) (n = 591). Worsening 10‐year CSS rates with increasing N status, M status, and SEER historic stage were demonstrated across all three above groups (all P < .05). In carcinoid tumor NOS, significant differences in CSS were found with increasing combined 8th AJCC stages (P < .001), except for that between stage II and stage III (10‐year CSS rate: 82.6% vs 84.3%, P = .68). While combined 8th TNM stage in NEC and OTC exhibited greater separations in CSS despite on‐going overlaps between groups. For carcinoid tumor NOS, stage II (HR = 3.37; 95% CI: 0.97‐11.76), and stage III (HR = 2.09; 95% CI: 0.51‐8.66) conferred no significant difference in CSS compared with stage I, while stage IV had an increasing HR of 5.09 (95% CI: 1.08‐24.08). Although combined 8th AJCC stage had a good ability to distinguish 10‐year CSS of patients with NEC or OCT, detailed 8th AJCC stage did not seem to be applicable. Detailed 8th AJCC categories of advanced stages in all the three groups conferred increased HRs with overlapping CIs. However, in the early and middle status, HRs did not increase with the increase of stages, or there was no difference in HRs between adjacent stages. Combined 8th TNM stage was not practical for judging the survival outcomes of colorectal carcinoid tumor NOS, especially in patients with stages II and III, but it provided useful prognostic information for NEC and OCT. However, for all carcinoid tumors, the prognostic values of detailed 8th AJCC stage were not enough accurate in the clinic. More optimized staging methods should be developed and validated in the future.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Prognostic significance for colorectal carcinoid tumors based on the 8th edition TNM staging system

et al. 2020

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“…The exact role of these techniques in different grades and stages of rectal NETs remains to be defined. In particular, there is interest in the fact that R1 resections (resections with an excision margin < 1 mm) can be performed, but recurrence in many of these cases does not occur within the first 5 years of follow-up [16-21]. It is therefore hard to know if repeat resection is needed, or whether an observation protocol will suffice.…”

Section: Rectal Netsmentioning

confidence: 99%

Colorectal Neuroendocrine Neoplasms: Areas of Unmet Need

Valle¹,

Dijkum

Sundín

et al. 2018

Neuroendocrinology

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The subject of colorectal neuroendocrine neoplasms (NENs), subdivided into well-differentiated NENs, termed neuroendocrine tumours (NETs; grade (G) 1 and 2), and poorly differentiated NENs, termed neuroendocrine carcinomas (NECs; G3) according to the 2010 World Health Organisation (WHO) classification, has arguably not had as much attention or study as NENs occurring in other sites. Colorectal NETs and NECs are however easier to study than many others since they are usually not difficult to remove and are increasingly detected because of intensified colorectal cancer screening and surveillance programmes. Colorectal NETs and NECs show site-specific heterogeneity with variable behaviour and different therapeutic options; these various aspects provide unique challenges. Because of bowel cancer screening programmes, colorectal NENs, like conventional adenocarcinomas, may be diagnosed at a stage that is associated with improved survival. In this article we intend to describe and define areas of unmet needs relating to the epidemiology, classification, pathology, diagnosis and therapy of colorectal NETs (including NETs G3), colorectal NECs, and finally, mixed adeno-neuroendocrine carcinomas (MANECs) by reviewing and discussing the relevant literature.

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“…Although these cells are distributed throughout the body, the most common site of disease is the gastrointestinal (GI) tract (1). Rectal NETs account for up to 27% of all NETs and 20% of gastrointestinal NETs (2)(3)(4). Colon NETs, which are less frequent, account for only 9.6% of all NETs and 14.1% of gastrointestinal NETs (2)(3)(4)(5)(6)(7)(8).…”

Section: Introductionmentioning

confidence: 99%

Factors associated with worse outcomes for colorectal neuroendocrine tumors in radical versus local resections

Osagiede

Habermann

Day

et al. 2020

J Gastrointest Oncol

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Background: Colorectal neuroendocrine tumors (NETs) are the most common NETs of the gastrointestinal tract. Due to the rarity, colorectal NETs are understudied and are not clearly understood.Our study sought to identify the factors associated with worse outcomes for colorectal NETs following resection. Methods: We identified patients diagnosed with colorectal NETs [2004][2005][2006][2007][2008][2009][2010][2011][2012][2013][2014] who underwent resection from the National Cancer Data Base. Non-NETs were excluded. Overall survival (OS) was evaluated using the Kaplan Meier method. Cox proportional hazards and logistic regression models were used to assess factors associated with radical versus local resection, OS and LOS. Results: A total of 7,967 colon and 11,929 rectal NETs were analyzed. The majority of colon (93.4%) and rectal (89.1%) NETs underwent radical and local resection respectively. The 5-year OS was 69% and 92% for colon and rectal NETs respectively. Older age (OR 1.45, CI 1.37-1.53) and clinical stage 4 (OR 9.91, CI 4.56-21.52) were associated with higher odds for colonic radical resection. Lowest median income quartile (OR 1.41, and African Americans (OR 1.26, CI 1.07-1.49) experienced higher mortality for colon and rectal NETs respectively. Conclusions: Racial minority and low-income patients experience worse outcomes for colorectal NETs following resection.

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Local excision results in comparable survival to radical resection for early-stage rectal carcinoid

Cited by 9 publications

References 24 publications

Prognostic significance for colorectal carcinoid tumors based on the 8th edition TNM staging system

Prognostic significance for colorectal carcinoid tumors based on the 8th edition TNM staging system

Colorectal Neuroendocrine Neoplasms: Areas of Unmet Need

Factors associated with worse outcomes for colorectal neuroendocrine tumors in radical versus local resections

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