Prognosis and risk factors of metastasis in colorectal carcinoids: results of a nationwide registry over 15 years

Abstract

Background: Colorectal carcinoids are often described as low-grade malignant. However, no study has compared the survival between patients with colorectal carcinoids and those with carcinomas, in a large series. In addition, no global consensus has been established on the crucial determinants of metastasis in colorectal carcinoids. Aim: To determine the predictive factors for metastasis in colorectal carcinoids and clarify their prognosis compared with adenocarcinomas. Methods: Data of all patients diagnosed as having colorectal carcinoids were extracted from a large nationwide database of colorectal tumours, the Multi-Institutional Registry of Large-Bowel Cancer in Japan, for the period from 1984 to 1998. Risk factors for lymph node (LN) metastases and distant metastases were analysed among those who were undergoing surgery, by univariate and multivariate analysis. Cancerspecific survival was also compared between patients with colorectal carcinoids and those with adenocarcinomas registered in the same period. Results: Among the 90 057 cases of colorectal tumours that were diagnosed, a total of 345 cases of carcinoids were identified, including 247 colorectal carcinoids of those undergoing surgery. Risk factors for LN metastasis were tumour size >11 mm and lymphatic invasion, whereas those for distant metastasis were tumour size >21 mm and venous invasion. Colorectal carcinoids without these risk factors exhibited no LN metastasis or distant metastasis. Cancer-specific survival of patients with colorectal carcinoids without metastasis was better than that of those with adenocarcinomas. However, the survival was similar between carcinoids and adenocarcinomas if the tumours had LN metastasis or distant metastasis. Conclusions: The presence of metastasis in colorectal carcinoids could lead to survival that is as poor as in adenocarcinomas. Tumours (10 mm and without lymphatic invasion could be curatively treated by local resection, but others would need radical LN dissection.

Clinicopathological Features and Prognosis of Gastroenteropancreatic Neuroendocrine Tumors: Analysis from a Single-institution

“…Our data show that the incidence of GEP-NENs has risen over the last 12 years, as has been reported in previous studies (Konishi et al, 2007;Ploeckinger et al, 2009;Garcia-Carbonero et al, 2010;Estrozi et al, 2011;Lim et al, 2011). In this study, we investigated the pathologic features of GEP-NENs using the latest histopathologic diagnosis consensus and analyzed overall survival by Univariate analysis and Cox proportional hazards regression modeling.…”

Postoperative complications after stapled and hand‐sewn ileal pouch‐anal anastomosis for familial adenomatous polyposis: A multicenter study

“…Original data for this study were compiled from 23 institutions that are members of the Japanese Society for Cancer of the Colon and Rectum (JSCCR), which includes the departments of surgery, internal medicine, pathology, and radiology at hospitals throughout Japan 19, 20. All patients diagnosed as having FAP and undergoing colorectal resection in each institution between the years 2000 and 2012 were retrospectively collected and registered for the database as described previously 16, 17, 18.…”

A 35‐year retrospective study of carcinoid tumors in Taiwan

“…A similar distribution of carcinoids was reported in a 15-year nationwide registry in Japan: The rates of carcinoids located in the rectum, nonrectal colon, appendix, and ileum were 88.6%, 8.2%, 2.3%, and 0.9% respectively. 22 Fifteen small rectal carcinoid tumors that ranged in size from 2 mm to 13 mm were identified in 21,522 healthy teachers who received proctosigmoidoscopy examination, suggesting that there is a high incidence of rectal carcinoids in Japanese populations. 23 In a smaller Taiwanese study, the primary sites of carcinoids in the gastrointestinal tract were the rectum (66%), duodenum (14%), stomach (8%), appendix (4%), ileum (4%), colon (2%) and cecum (2%), and the M/F ratio was 2.3.…”