Neuroendokrine Tumoren des Rektums: endoskopische Therapie

Eick, Jan; Steinberg, J.; Schwertner, C.; Ring, Wanda; Scherübl, Hans

doi:10.1007/s00104-015-0141-6

Cited by 6 publications

(5 citation statements)

References 10 publications

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“…Zur genauen Größenbestimmung des Rektum-NET, zum Ausschluss einer Infiltration tieferer Darmwandschichten (Muscularis propria) sowie zum Ausschluss von Lymphknotenmetastasen soll vor der endoskopischen Resektion eine Endosonografie erfolgen [265].…”

Section: Empfehlung Starker Konsensunclassified

“…Empfehlung bzw. offene Empfehlung, starker Konsens Es handelt sich hierbei immer um Rektum-NET von < 1 cm im Durchmesser; i. d. R. sind es 1 -5 mm große, gut differenzierte (G1-) NET, die mittels Biopsiezange abgetragen wurden und histologisch keine lymphovaskuläre Infiltration aufweisen [257,265]. Angesichts der guten Prognose von 1 -5 mm großen, gut differenzierten (G1) und nicht-angioinvasiv wachsenden NET des Rektums ist eine rektoskopische und endosonografische Kontrolluntersuchung nach 1 Jahr ausreichend.…”

Section: Empfehlung 321unclassified

See 1 more Smart Citation

S2k-Leitlinie Neuroendokrine Tumore

Gastroenterologie¹,

Tumoren²,

e.V.³

et al. 2018

Z Gastroenterol

128

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Section: Empfehlung Starker Konsensunclassified

Section: Empfehlung 321unclassified

S2k-Leitlinie Neuroendokrine Tumore

Gastroenterologie¹,

Tumoren²,

e.V.³

et al. 2018

Z Gastroenterol

128

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“…Currently, the treatment options for CRNETs primarily involve endoscopic resection (ER) or surgical resection (SR) based on staging, while unresectable cases require medical therapy ( 10 ). For CRNETs with a diameter smaller than 10mm, ER treatment is typically recommended ( 11 ), whereas for larger lesions, partial or total intestinal resection through SR is chosen to reduce recurrence rates and improve patient prognosis ( 12 , 13 ). However, the optimal treatment strategy for CRNETs with a diameter between 10-20mm has not been definitively determined.…”

Section: Introductionmentioning

confidence: 99%

Comparing surgical and endoscopic resection approaches for colorectal neuroendocrine tumors within the diameter range of 10-20mm: an inverse probability weighting analysis based on the SEER database

Xu,

Liang,

Cai

et al. 2024

Front. Endocrinol.

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BackgroundCurrently, the primary treatment modalities for colorectal neuroendocrine tumors (CRNET) with a diameter between 10mm and 20mm are surgical resection (SR) and endoscopic resection (ER). However, it remains unclear which surgical approach yields the greatest survival benefit for patients.MethodsThis study included data from patients diagnosed with CRNET with tumor diameters ranging from 10mm to 20mm between the years 2004 and 2019, obtained from the Surveillance, Epidemiology, and End Results (SEER) database. Patients were categorized into ER and SR groups based on the respective surgical approaches. Inverse probability weighting (IPTW) was employed to mitigate selection bias. Kaplan-Meier analysis and log-rank tests were utilized to estimate overall survival (OS) and cancer-specific survival (CSS). Cox regression analysis (univariate and multivariate) was performed to evaluate potential factors influencing survival.ResultsA total of 292 CRNET patients were included in this study (ER group: 108 individuals, SR group: 184 individuals). Prior to IPTW adjustment, Kaplan-Meier analysis and Cox proportional hazard regression analysis demonstrated that the OS and CSS of the SR group were inferior to those of the ER group. However, after IPTW adjustment, no statistically significant differences in prognosis were observed between the two groups. Subgroup analyses revealed that patients with muscular invasion, positive lymph nodes, or distant metastasis derived greater survival benefits from SR. Significant differences in OS and CSS between the two groups were also observed across different age groups.ConclusionFor patients with mucosal-limited lesions and without local lymph node or distant metastasis, ER is the preferred surgical approach. However, for patients with muscular invasion or positive lymph nodes/distant metastasis, SR offers a better prognosis. The choice of surgical approach should be based on the specific clinical characteristics of patients within different subgroups.

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“…Rectal neuroendocrine tumors (NETs) are small but potentially malignant tumors, which were once considered rare. However, due to the rapid prevalence of colonoscopy in the past few decades, the global incidence of rectal NETs has increased by several to a dozen times, while the detection rate via colonoscopy is about 0.05-0.07% (1)(2)(3)(4)(5)(6). In Asia, the rectum is the most common primary site for gastroenteropancreatic NETs, of which rectal NETs account for 60-89%.…”

Section: Introductionmentioning

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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Neuroendokrine Tumoren des Rektums: endoskopische Therapie

Cited by 6 publications

References 10 publications

S2k-Leitlinie Neuroendokrine Tumore

S2k-Leitlinie Neuroendokrine Tumore

Comparing surgical and endoscopic resection approaches for colorectal neuroendocrine tumors within the diameter range of 10-20mm: an inverse probability weighting analysis based on the SEER database

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

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