EMR-P for small rectal neuroendocrine tumors: is it a preferred treatment?

Liu, Zhaohui; Zheng, Chunsi; Ding, Shilei; Chen, Chong; Yang, Jun; Wu, Ruinuan; Sun, Dongdong

doi:10.1080/00365521.2022.2090854

Cited by 3 publications

(1 citation statement)

References 14 publications

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“…10 At initial diagnosis, R-NETs are more often small, localized lesions, with a low risk of distal metastasis; thus, the prognosis is good, with an overall 5-year survival rate >75%. 21 The detection rate of R-NETs has increased with the improvement of physicians' knowledge of R-NETs, the popularization of endoscopy screening and surveillance, and the development of endoscopic ultrasound technology. Consequently, questions have arisen regarding the optimal therapeutic approach.…”

Section: Discussionmentioning

confidence: 99%

Optimization of Endoscopic Submucosal Dissection and Endoscopic Mucosal Resection Strategies for Rectal Neuroendocrine Tumors Within 20 mm

Yu,

Zhang,

et al. 2024

The American Surgeon™

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Aims No consensus regarding the optimal endoscopic resection approach for rectal neuroendocrine tumors (R-NETs) measuring 10-20 mm, this study aims to investigate this issue. Methods Patients with R-NETs underwent either endoscopic mucosal resection (EMR) or endoscopic submucosal dissection (ESD). The primary endpoint was the complete resection rate, and the secondary endpoints were surgery-related complications and long-term outcomes. Results 96 patients met the inclusion criteria, 84 patients completed endoscopic resection, and 5 patients were excluded. 79 patients were enrolled and divided into EMR (n = 21) and ESD groups (n = 58). 100% of ESD excisions reached the primary endpoint, while 90.5% of EMR. Endoscopic submucosal dissection can achieve higher R0 rate and lower positive margin rate than EMR. The mean operative time of ESD and EMR was 35.22 ± 8.96 min and 13.14 ± 3.26 min, respectively. The complication rates of ESD and EMR were 3.4% and 4.8%, respectively. For R-NETs between 10 mm and 20 mm, the R0 rate of ESD was significantly higher than that of EMR (100% vs 71.4%, P = .01) and the margin positive rate of ESD was significant lower than that of EMR (4.8% vs 42.9%, P < .05). Both ESD and EMR obtained 100% R0 resection of less than 10 mm R-NET. The median follow-up was 13 months (3-84 months); 1 patient relapsed 25 months after EMR and was re-treated with ESD. Conclusion For R-NETs with a diameter less than 10 mm, both EMR and ESD were safe and effective and EMR is convenient and fast, with advantages. ESD offers superiority for R-NETs between 10 and 20 mm and can be considered as the preferred method.

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Section: Discussionmentioning

confidence: 99%