A novel risk‐scoring system for predicting lymph node metastasis of rectal neuroendocrine tumors

Chida, Keigo; Watanabe, Jun; Hirasawa, Kingo; Inayama, Yoshiaki; Misumi, Toshihiro; Kunisaki, Chikara; Endo, Itaru

doi:10.1002/ags3.12355

Cited by 14 publications

(10 citation statements)

References 35 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…We showed that tumor size greater than 11.5 mm and vascular invasion were independent risk factors for lymph node metastases. Nevertheless, despite what is reported in the current ENETS guidelines, our investigation lowered the dimensional cutoff for clinical decisions from 20 mm to 11.5 mm in line with the results from the latest retrospective analyses regarding r-NETs [13,[32][33][34][35]. Similar to our findings, two large retrospective studies based on national registries published in 2019 and a retrospective report from the French group of endocrine tumors (GTE) confirmed that tumor size larger than 10 mm was related to nodal involvement in non-metastatic r-NETs, along with other predictive factors, such as tumor grade and presence of muscular and lymphovascular invasion [33][34][35].…”

Section: Discussionsupporting

confidence: 81%

“…The incidence of r-NETs has been increasing in recent decades and, despite the overall good prognosis, the long-term prognosis of r-NETs is comparable to that of colorectal cancer in the case of nodal involvement [13,18,19]. Thus, a risk stratification-based approach could suggest the appropriate surgical or endoscopic management in this setting.…”

Section: Discussionmentioning

confidence: 99%

“…Conversely, in the case of r-NETs 10 mm to 20 mm and larger than 20 mm in size, the reported incidence of nodal involvement increases to 30% and 60%, respectively, with a worse prognosis [7][8][9]. Previous studies have shown that a tumor size of >10 mm or >20 mm, stage, depth of submucosal invasion, lymphovascular invasion (LVI), or tumor grade 3 (G3) are important predictors of lymph node metastases, but the risk factors for nodal involvement have not been clearly elucidated [3,[10][11][12][13][14].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Assessment of the Risk of Nodal Involvement in Rectal Neuroendocrine Neoplasms: The NOVARA Score, a Multicentre Retrospective Study

Ricci

Pusceddu

Panzuto

et al. 2022

JCM

View full text Add to dashboard Cite

Rectal neuroendocrine tumors (r-NETs) are rare tumors with overall good prognosis after complete resection. However, there is no consensus on the extension of lymphadenectomy or regarding contraindications to extensive resection. In this study, we aim to identify predictive factors that correlate with nodal metastasis in patients affected by G1–G2 r-NETs. A retrospective analysis of G1–G2 r-NETs patients from eight tertiary Italian centers was performed. From January 1990 to January 2020, 210 patients were considered and 199 were included in the analysis. The data for nodal status were available for 159 cases. The nodal involvement rate was 9%. A receiver operating characteristic (ROC) curve analysis was performed to identify the diameter (>11.5 mm) and Ki-67 (3.5%), respectively, as cutoff values to predict nodal involvement. In a multivariate analysis, diameter > 11.5 mm and vascular infiltration were independently correlated with nodal involvement. A risk scoring system was constructed using these two predictive factors. Tumor size and vascular invasion are predictors of nodal involvement. In addition, tumor size > 11.5 mm is used as a driving parameter of better-tailored treatment during pre-operative assessment. Data from prospective studies are needed to validate these results and to guide decision-making in r-NETs patients in clinical practice.

show abstract

Section: Discussionsupporting

confidence: 81%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Assessment of the Risk of Nodal Involvement in Rectal Neuroendocrine Neoplasms: The NOVARA Score, a Multicentre Retrospective Study

Ricci

Pusceddu

Panzuto

et al. 2022

JCM

View full text Add to dashboard Cite

show abstract

“…There have been fewer studies regarding the tumor grade than other factors because these grades were first described in the WHO classification of digestive system tumors in 2010 [ 11 ]. While some studies have reported that the tumor grade was a significant predictor [ 6 , 9 , 13 ], others have concluded that the tumor grade did not play a part in prediction of LNM [ 14 ]. In this study, 83% (5/6) of the patients with tumor grade 2 had LNM.…”

Section: Discussionmentioning

confidence: 99%

Tumor grade 2 as the independent predictor for lymph node metastasis in 10–20 mm sized rectal neuroendocrine tumor

Park

Cho

Son

et al. 2021

Korean J Clin Oncol

View full text Add to dashboard Cite

Purpose: Rectal neuroendocrine tumors (NETs) <10 mm are endoscopically resected, while those ≥20 mm are treated with radical surgical resection. The choice of treatment for 10–20 mm sized rectal NETs remains controversial. This study aimed to verify factors predicting lymph node metastasis (LNM) of 10–20 mm sized rectal NET and utilize them to decide upon the treatment strategy.Methods: Twenty-eight patients with 10–20 mm sized rectal NETs treated at Pusan National University Yangsan Hospital from January 2009 to September 2020 were divided into LNM (+) and LNM (–) groups, and their respective data were analyzed.Results: Seven patients (25%) had LNM while 21 patients (75%) did not. Endorectal ultrasound findings showed tumor size was significantly larger in the LNM (+) than in the LNM (–) group (15 mm vs. 10 mm, P=0.018); however, pathologically, there was no significant difference in tumor size (13 mm vs. 11 mm, P=0.109). The mitotic count (P=0.011), Ki-67 index (P=0.008), and proportion of tumor grade 2 patients (5 cases, 71% vs. 1 case, 5%; P=0.001) were significantly higher in the LNM (+) group. In multivariate analysis, tumor grade 2 was the independent factor predicting LNM (odds ratio, 61.32; 95% confidence interval, 3.17–1,188.64; P=0.010).Conclusion: Tumor grade 2 was the independent factor predicting LNM in 10–20 mm sized rectal NETs. Therefore, it could be considered as the meaningful factor in determining whether radical resection is necessary.

show abstract

“…9,29,31,35,36 Correlation between tumour size and lymphovascular invasion has also been demonstrated with a tumour size ≥5 mm at higher risk of lymphovascular involvement than in tumours with a size <5 mm, 36 and predictive scores taking into account both, the tumour size and the lymphovascular involvement have been shown to provide an accurate assessment of the risk of metastatic lymph node involvement. 37,38 Computed tomography (CT) has limited value for the detection and characterisation of regional metastatic lymph nodes in patients with rNET. 39 Similarly to rectal adenocarcinoma, MRI with diffusionweighted imaging (DWI) is considered as the most sensitive imaging method for regional lymph node detection, detection of residual disease after incomplete resection, and the involvement of pelvic structures in more advanced tumours.…”

Section: Introductionmentioning

confidence: 99%

European Neuroendocrine Tumor Society (ENETS) 2023 guidance paper for colorectal neuroendocrine tumours

Rinke

Ambrosini

Dromain

et al. 2023

J Neuroendocrinology

View full text Add to dashboard Cite

This ENETS guidance paper, developed by a multidisciplinary working group, provides an update on the previous colorectal guidance paper in a different format. Guided by key clinical questions practical advice on the diagnosis and management of neuroendocrine tumours (NET) of the caecum, colon, and rectum is provided. Although covered in one guidance paper colorectal NET comprises a heterogeneous group of neoplasms. The most common rectal NET are often small G1 tumours that can be treated by adequate endoscopic resection techniques. Evidence from prospective clinical trials on the treatment of metastatic colorectal NET is limited and discussion of patients in experienced multidisciplinary tumour boards strongly recommended.Neuroendocrine carcinomas (NEC) and mixed neuroendocrine non-neuroendocrine neoplasms (MiNEN) are discussed in a separate guidance paper.

show abstract

A novel risk‐scoring system for predicting lymph node metastasis of rectal neuroendocrine tumors

Abstract: This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

Cited by 14 publications

References 35 publications

Assessment of the Risk of Nodal Involvement in Rectal Neuroendocrine Neoplasms: The NOVARA Score, a Multicentre Retrospective Study

Assessment of the Risk of Nodal Involvement in Rectal Neuroendocrine Neoplasms: The NOVARA Score, a Multicentre Retrospective Study

Tumor grade 2 as the independent predictor for lymph node metastasis in 10–20 mm sized rectal neuroendocrine tumor

European Neuroendocrine Tumor Society (ENETS) 2023 guidance paper for colorectal neuroendocrine tumours

Contact Info

Product

Resources

About