Lymph-node metastases in rectal carcinoids

Fujimoto, Yoshiya; Oya, Mototsugu; Kuroyanagi, Hiroya; Ueno, Masashi; Akiyoshi, Takashi; Yamaguchi, Toshiharu; Muto, Tetsuichiro

doi:10.1007/s00423-008-0438-8

Cited by 33 publications

(30 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In their evaluation of specimens from endoscopic resection, Fijimoto et al reported that 70% of the patients had lymph node metastasis with tumor sizes of 0-30 mm. The incidence of lymph node metastasis in the present study is significantly higher compared with that in previous reports, suggesting that the Fujimoto's criteria for radical resection are appropriate (24). Of note, two of three lesions sized <10 mm with lymph node metastasis were accompanied by lymphovascular invasion, confirming that lymphovascular invasion may be an important predictor of lymph node metastasis.…”

Section: Discussionsupporting

confidence: 47%

Evaluation of treatment for rectal neuroendocrine tumors sized under 20 mm in comparison with the WHO 2010 guidelines

Matsuhashi

Takahashi

Tomita

et al. 2017

Molecular and Clinical Oncology

View full text Add to dashboard Cite

Abstract. Rectal neuroendocrine tumor (NET) is a relatively rare lesion of the gastrointestinal tract, but the prospective examination with colonofiberoscopy or endoscopic ultrasound has increased the frequency of its detection. It is often difficult to determine the optimal treatment for NETs sized <20 mm in the clinical setting. Other clinicopathological variables are not considered in the current guidelines and staging systems. Although the effects of lymphovascular invasion are not covered by the World Health Organization (WHO) 2010 guidelines or tumor-node-metastasis (TNM) staging system, this may be promising for the establishment of improved guidelines and staging systems, particularly for early-stage colorectal carcinoids. The aim of the present study was to evaluate rectal NETs sized <20 mm in comparison with the WHO 2010 guidelines. Between January 2005 and December 2013, 40 consecutive patients [26 men and 14 women; median age, 59.3 years (range, 34-81 years)] who underwent endoscopic resection of rectal NETs, and 12 patients undergoing surgical resection of rectal NETs, were enrolled in this retrospective study. The median tumor size was 7.4 mm (range, 3-15 mm). The locations of the NET were the rectosigmoid colon (n=3), the upper rectum (n=13), and the lower rectum (n=25). The NETs were classified by size as 0-5 (n=7), 6-10 (n=29) and 11-15 mm (n=4). The surgical procedures performed included low anterior resection plus esophagectomy (n=1), laparoscopic low anterior resection (n=7) and laparoscopic intersphincteric resection (n=4). Only 1 patient had lymph node metastasis (tumor sized 6-10 mm, with lymphovascular invasion). NET recurrence was not detected in any of the patients. According to the WHO guidelines, the tumors were classified as grade (G)1 (n=8), G2 (n=3) and G1/G2 (n=1). The tumor in the patient with lymph node metastasis was G1. NETs sized <10 mm may be curatively treated by endoscopic resection. However, NETs with either lymphovascular invasion or sized >1 cm carry a risk for metastasis equivalent to that of adenocarcinomas. Therefore, it is mandatory to histologically examine lymphovascular invasion in specimens retrieved via endoscopic resection to determine the necessity for further radical surgery with regional lymph node dissection. The treatment of NETs sized <20 mm as presently defined in the WHO 2010 guidelines requires further evaluation.

show abstract

Section: Discussionsupporting

confidence: 47%

Evaluation of treatment for rectal neuroendocrine tumors sized under 20 mm in comparison with the WHO 2010 guidelines

Matsuhashi

Takahashi

Tomita

et al. 2017

Molecular and Clinical Oncology

View full text Add to dashboard Cite

show abstract

“…Based on the fact that rectal NETs that are small and confined to the submucosal layer rarely metastasize, these lesions are usually treated by local excision, including ER [2,3,[8][9][10][11][12][13][14]. However, small rectal NETs, including those less than 10 mm in size, can also metastasize [8][9][10][11][12][14][15][16][17]; therefore, identification of additional clinicopathological factors that could influence the risk of metastasis may help determine the most appropriate management.…”

Section: Introductionmentioning

confidence: 99%

Excellent prognosis following endoscopic resection of patients with rectal neuroendocrine tumors despite the frequent presence of lymphovascular invasion

et al. 2015

View full text Add to dashboard Cite

show abstract

“…Endoscopic treatment was performed prior to surgery in 7 patients (cases 2, 3, 5, 7, 11, 17 and 19). Trans-anal local resection was performed in 4 patients (cases [17][18][19][20] and each of those cases was followed for >70 months (mean, 116), with no recurrence identified at the time of writing. Radical surgery consisting of rectal resection with a lymphadenectomy was performed in 16 (cases 1-16) of the 20 patients (Table II).…”

Section: Resultsmentioning

confidence: 99%

“…A few authors have warned that a small rectal carcinoid has the potential to metastasize to the lymph nodes or other distant organs (9)(10)(11)19), while others have reported that small rectal carcinoids were managed endoscopically without recurrence (8,(20)(21)(22).…”

Section: Introductionmentioning

confidence: 99%

Clinicopathological characteristics of rectal carcinoid patients undergoing surgical resection

et al. 2012

View full text Add to dashboard Cite

Abstract. The aim of this study was to clarify the clinical aspects, histopathological features and prognosis of patients with rectal carcinoids, focusing on properties associated with metastasis, in order to gain insights into appropriate management. A total of 20 patients (15 males, 5 females; mean age, 54.9 years; range, 23-71) who underwent surgery for rectal carcinoid tumors at the Department of Colorectal Surgery, Hyogo College of Medicine, between May 2000 and January 2011 were analyzed. Ki-67 immunostaining was performed in 13 cases with available tumor tissue specimens. Of the 20 patients, a radical operation including rectal resection with a lymphadenectomy was performed in 16. The mean tumor size was 11.9 mm (3-25 mm) and lymph node metastasis was confirmed in 9 cases, including 3 with lesions no greater than 7 mm in diameter. Overall, 16 (80%) of the tumors were localized in the submucosal layer and 4 (20%) involved the proper muscle layer. Ki-67 labeling index and lymphovascular invasion were shown to be associated with lymph node and/or distant metastasis by multiple logistic regression analysis, but were not statistically significant in ANOVA findings. Lymph node metastasis from rectal carcinoids, even those smaller than 10 mm in diameter, was not a rare event. More attention should be given to decision-making, including the possibility of endoscopic resection for the treatment of rectal carcinoid tumors regardless of size.

show abstract

Lymph-node metastases in rectal carcinoids

Cited by 33 publications

References 11 publications

Evaluation of treatment for rectal neuroendocrine tumors sized under 20 mm in comparison with the WHO 2010 guidelines

Evaluation of treatment for rectal neuroendocrine tumors sized under 20 mm in comparison with the WHO 2010 guidelines

Excellent prognosis following endoscopic resection of patients with rectal neuroendocrine tumors despite the frequent presence of lymphovascular invasion

Clinicopathological characteristics of rectal carcinoid patients undergoing surgical resection

Contact Info

Product

Resources

About