Risk Factors and Clinical Outcomes of 54 Cases of Rectal Neuroendocrine Tumors with Incomplete Resection: A Retrospective Single-Center Study

Li, Yan; Pan, Fei; Wang, Zi-Kai; Meng, Ke; Peng, Lihua; Lu, Zhong-sheng; Dou, Yan; Bin, Yan; Liu, Qingsen

doi:10.2147/tcrm.s332838

Cited by 7 publications

(20 citation statements)

References 22 publications

(24 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…All patients with rectal NETs underwent treatments including EMR, precutting EMR and ESD. No recurrence of the tumors was observed in the patients with incomplete resection during the follow-up period ( 19 ). On the whole, positive lesion margins do not indicate tumor recurrence.…”

Section: Discussionmentioning

confidence: 95%

Comparison of the efficacy of endoscopic submucosal dissection and transanal endoscopic microsurgery in the treatment of rectal neuroendocrine tumors ≤ 2 cm

Jin

Bai

et al. 2023

Front. Endocrinol.

View full text Add to dashboard Cite

IntroductionCurrently, complete tumor resection is considered the most effective treatment for rectal neuroendocrine tumors (NETs). Endoscopic submucosal dissection (ESD) and transanal endoscopic microsurgery (TEM) are recommended for rectalNETs ≤2 cm, but it is not clear which method is better. Thus, we evaluated the efficacy of ESD and TEM in the treatment of rectal neuroendocrine tumors (NETs) ≤ 2 cm.MethodsWe conducted a single-centre retrospective cohort study between 2010 and 2021 of rectal NETs ≤ 2 cm in 114 patients with long-term follow-up data who were divided into ESD (n=55) and TEM groups (n=59). Our study assessed differences between groups in the complete resection rate of lesions, recurrence rate, surgical complications, procedure time, and length of hospital stay.ResultsThe co-primary outcomes were the complete resection rate of lesions and the recurrence rate. Compared to that in the ESD group, the complete resection rate was significantly higher in the TEM group (91.5% vs. 70.9%, p=0.005). The median follow-up time was 22 months in our study, and the follow-up outcomes suggested that the rates of recurrence were 1.8% (1/55) and 6.8% (4/59) in the ESD and TEM groups, respectively, with no significant difference between the two groups. The secondary outcomes of the evaluation were surgical complications, procedural time, and length of hospital stay. The rate of complications (gastrointestinal bleeding and perforation) was low in both the ESD (7.3%, 4/55) and TEM (5.1%, 3/59) groups. No difference in hospitalization duration was observed between the two groups in our study. However, the procedure time was significantly shorter in the ESD group than in the TEM group (27.5 min vs. 56 min, p<0.001).ConclusionsAlthough the rate of complete resection in the TEM group was higher than that in the ESD group, there was no difference in recurrence rates between the two modalities during long-term follow-up. Depending on the qualities of the available hospital resources in the area, one of the two approaches can be adopted.

show abstract

Section: Discussionmentioning

confidence: 95%

Comparison of the efficacy of endoscopic submucosal dissection and transanal endoscopic microsurgery in the treatment of rectal neuroendocrine tumors ≤ 2 cm

Jin

Bai

et al. 2023

Front. Endocrinol.

View full text Add to dashboard Cite

show abstract

“…Similarly, a study conducted in South Korea of 107 patients also indicated that the clinical outcomes for RNETs (≤10 mm in size) achieved excellent outcomes after a median follow-up period of 31 months, regardless of the margin status [ 29 ]. It has been also reported that of the 428 small RNETs (<1 cm), all 54 IR cases without salvage treatment found no recurrence during the 10- to 110-month follow-up period [ 10 ]. Additionally, the research by Hyun Jung Lee et al [ 30 ] showed that of 142 patients with IR lesions, ≤98 (69.0%) were willing to receive regular colonoscopy follow-up and found no recurrences and metastasis, presenting a prognosis comparable to that of the remaining 44 patients who received salvage treatment.…”

Section: Discussionmentioning

confidence: 99%

Risk factors and clinical outcomes of incomplete endoscopic resection of small rectal neuroendocrine tumors in southern China: a 9-year data analysis

Zhuang

Zhang

Chen

et al. 2022

Gastroenterology Report

View full text Add to dashboard Cite

Background The histologically complete resection (CR) rate of small rectal neuroendocrine tumors (RNETs) is unsatisfactory at the first endoscopy. Risk factors and clinical outcomes associated with incomplete resection (IR) have not been explicitly elucidated. This study aims to explore the relevant factors of IR. Methods This retrospective study reviewed patients with small RNETs (≤10 mm) in eight centers from January 2013 to December 2021. Clinicopathological characteristics and clinical outcomes were compared between the CR and IR groups, and the polypectomy and advanced treatment groups. Results Of the 326 patients included, 83 (25.5%) were diagnosed with IR. Polypectomy (odds ratio [OR] = 16.86), a central depression (OR = 7.50), and treatment in the early period (OR = 2.60) were closely associated with IR. Further analysis revealed that an atypical hyperemic appearance (OR = 7.49) and treatment in the early period (OR = 2.54) were significantly associated with the inappropriate use of polypectomy (both P < 0.05). In addition, a total of 265 (81.3%) were followed up with a median follow-up period of 30.9 months. No death, metastasis, or recurrence was found during the follow-up period. Conclusions Polypectomy, a central depression, and treatment in the early period were risk factors for IR. Further, an atypical hyperemic appearance and treatment in the early period were significant predisposing factors for inappropriate choice of polypectomy. For histologically incompletely resected small RNETs, follow-up may be a safe and feasible alternative to rigorous salvage therapy.

show abstract

“…[53] A multicenter retrospective study in Korea focused on positive margins and indeterminate cases and found that the long-term prognosis is good even if no treatment is administered to patients with positive or indeterminate margins. [54,55] In another study of 77 G1 NET patients with positive surgical margins, 31 patients did not receive additional treatment and did not develop recurrence. [56]…”

Section: Methodsmentioning

confidence: 99%

“…[53] A multicenter retrospective study in Korea focused on positive margins and indeterminate cases and found that the long-term prognosis is good even if no treatment is administered to patients with positive or indeterminate margins. [54,55] Figure 2. Treatment strategies for well-differentiated rectal NETs in the (NCCN) guidelines.…”

Section: Guidelinesmentioning

confidence: 99%

Treatment of localized well-differentiated rectal neuroendocrine tumors: A focused review

et al. 2023

View full text Add to dashboard Cite

The frequency of rectal neuroendocrine tumors increases with the increase in the number of colonoscopies performed for colorectal cancer screening. The treatment of localized rectal well-differentiated neuroendocrine tumors involves local excision, including endoscopic treatment or rectal resection with lymphadenectomy. Although it is important to determine the risk of lymph node metastasis, there are points of disagreement among the guidelines regarding surgical indications. In this review, we discuss the current status of the treatment of well-differentiated rectal neuroendocrine tumors. The PubMed database was searched for relevant studies. In Japan, the criteria for curative endoscopic resection are very strict: less than 10 mm, G1, no invasion of the muscularis propria, no suspicion of lymph node metastasis, and no lymphovascular invasion. Meanwhile, in Western guidelines, local excision (endoscopic treatment is preferable) is recommended as the initial treatment for tumors measuring ≥10 mm and <20 mm in diameter, and radical surgery is recommended for tumors ≥20 mm in diameter. There are still many points where evidence is lacking, and future research is warranted.

show abstract

Risk Factors and Clinical Outcomes of 54 Cases of Rectal Neuroendocrine Tumors with Incomplete Resection: A Retrospective Single-Center Study

Cited by 7 publications

References 22 publications

Comparison of the efficacy of endoscopic submucosal dissection and transanal endoscopic microsurgery in the treatment of rectal neuroendocrine tumors ≤ 2 cm

Comparison of the efficacy of endoscopic submucosal dissection and transanal endoscopic microsurgery in the treatment of rectal neuroendocrine tumors ≤ 2 cm

Risk factors and clinical outcomes of incomplete endoscopic resection of small rectal neuroendocrine tumors in southern China: a 9-year data analysis

Treatment of localized well-differentiated rectal neuroendocrine tumors: A focused review

Contact Info

Product

Resources

About