Endoscopic submucosal resection with a ligation device is an effective and safe treatment for carcinoid tumors in the lower rectum

Mashimo, Yumi; Matsuda, Takahisa; Uraoka, Toshio; Saito, Yutaka; Sano, Yasushi; Fu, Kuang‐I; Kozu, Takahiro; Ono, Akiko; Fujii, Takeshi; Saito, Daizo

doi:10.1111/j.1440-1746.2008.05313.x

Cited by 116 publications

(118 citation statements)

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“…The management and therapy of tumors 1-2 cm in size is controversial, but most will benefit from local treatment, with polypectomy versus band-assisted resection (32)(33)(34). Most of our cases were treated with polypectomy, band-assisted mucosectomy, and TEM.…”

Section: Discussionmentioning

confidence: 99%

Gastrointestinal carcinoid tumors

Varas-Lorenzo¹,

Muñoz-Agel²,

Espinós-Pérez³

et al. 2010

Rev. esp. enferm. dig.

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Carcinoid tumors (CTs) were described more than 100 years ago by Oberndorfer (1,2). MacDonald (1) found 0.02% carcinoids in surgical cases, and 1% in necropsies.The incidence of carcinoid tumors has increased over time from 0.32/100,000 population and year (3) in the only community-based study available to 1-2 cases/100,000/year (4,5), and then further to 4.4/ 100,000/year (6,7); the rate in surgical specimens and necropsies was 8.4/100,000/year in Sweden during a 12-year period of time (8). The one study in our country (9) points out an incidence of 0.7/100,000 population/year for all CTs (0.125% in necropsies).CTs occur twice as much in Afro-American than in Caucasian patients (10). Gender distribution is similar, REV ESP ENFERM DIG (Madrid) Vol. 102. N.°9, pp. 533-537, 2010 Received: 29-10-09. Accepted: 25-02-10.Correspondence: M. J. Varas Lorenzo. Centro Médico Teknon. C/ Marquesa de Vilallonga, 12. 08017 Barcelona. Spain. e-mail: varas@dr.teknon.es Varas-Lorenzo MJ, Muñoz-Agel F, Espinós-Pérez JC, Bardají-Bofill M. Gastrointestinal carcinoid tumors. Rev Esp Enferm Dig 2010; 102: 533-537. ORIGINAL PAPERS ABSTRACTObjective: carcinoid tumors (CTs) represent the commonest neuroendocrine tumors.Those in the gastrointestinal tract are diagnosed in surgical specimens, clinically, and using imaging techniques (endoscopy, echoendoscopy, CT, Octreoscan, etc.).The goal of this retrospective study was to review a personal series of gastrointestinal carcinoid tumors, and to compare it to those in the literature.Patients and methods: the medical records of 40 Caucasian patients with over 50 gastrointestinal carcinoid tumors (including multiple cases) who were seen for a period of 16 years (1994)(1995)(1996)(1997)(1998)(1999)(2000)(2001)(2002)(2003)(2004)(2005)(2006)(2007)(2008)(2009) were reviewed.Results: mean age at presentation was 52 years, 50% were females, and mean tumor size was 9.9 mm. Most were gastroduodenal (42.5%) or rectal (30%), and were treated endoscopically. Metastases and carcinoid syndrome (CS) were seen in 5% of patients. Survival at study endpoint was 85%.Conclusions: age and gender were consistent with the literature. There was an increase in gastroduodenal (multifocal) and rectal carcinoids, likely because the series was essentially endoscopical in nature (bias). There was a lower rate of CS and higher survival, likely due to earlier diagnosis and treatment.Key words: Gastrointestinal carcinoid tumors. Neuroendocrine tumors. Carcinoid syndrome. RESUMENObjetivo: los tumores carcinoides (TC) son los tumores neuroendocrinos más frecuentes. Los digestivos se diagnostican en las piezas quirúrgicas, en la clínica, y mediante los métodos de imagen (endoscopia, ecoendoscopia, TAC y Octreoscan, etc.).El objetivo de este trabajo retrospectivo fue revisar una serie personal de tumores carcinoides digestivos y compararla con la literatura.Pacientes y métodos: se revisaron las historias clínicas de 40 pacientes de raza blanca con más de 50 tumores carcinoides digestivos, algunos múltiples, observados du...

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Section: Discussionmentioning

confidence: 99%

Gastrointestinal carcinoid tumors

Varas-Lorenzo¹,

Muñoz-Agel²,

Espinós-Pérez³

et al. 2010

Rev. esp. enferm. dig.

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“…The Ki-67 index is known to be a marker of proliferative capacity in cases of breast cancer and other various malignancies (28), while certain authors have noted that Ki-67 is useful for a metastatic index of carcinoid tumors (4,(29)(30)(31). Hotta et al reported that Ki-67 is a reliable microscopic marker to predict the metastatic potential of rectal carcinoids (7).…”

Section: Discussionmentioning

confidence: 99%

Clinicopathological characteristics of rectal carcinoid patients undergoing surgical resection

et al. 2012

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Abstract. The aim of this study was to clarify the clinical aspects, histopathological features and prognosis of patients with rectal carcinoids, focusing on properties associated with metastasis, in order to gain insights into appropriate management. A total of 20 patients (15 males, 5 females; mean age, 54.9 years; range, 23-71) who underwent surgery for rectal carcinoid tumors at the Department of Colorectal Surgery, Hyogo College of Medicine, between May 2000 and January 2011 were analyzed. Ki-67 immunostaining was performed in 13 cases with available tumor tissue specimens. Of the 20 patients, a radical operation including rectal resection with a lymphadenectomy was performed in 16. The mean tumor size was 11.9 mm (3-25 mm) and lymph node metastasis was confirmed in 9 cases, including 3 with lesions no greater than 7 mm in diameter. Overall, 16 (80%) of the tumors were localized in the submucosal layer and 4 (20%) involved the proper muscle layer. Ki-67 labeling index and lymphovascular invasion were shown to be associated with lymph node and/or distant metastasis by multiple logistic regression analysis, but were not statistically significant in ANOVA findings. Lymph node metastasis from rectal carcinoids, even those smaller than 10 mm in diameter, was not a rare event. More attention should be given to decision-making, including the possibility of endoscopic resection for the treatment of rectal carcinoid tumors regardless of size.

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“…1 In this retrospective review, they report the results of 63 resections, with complete resection achieved in 95.2% of patients. This is the largest study of endoscopic therapy in the treatment of colorectal carcinoid and supports the growing evidence that these lesions, if properly selected, may be amenable to endoscopic intervention.…”

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“…However, IGT particularly occurs in chronic hepatitis C, alcoholic liver disease and nonalcoholic fatty liver disease so additional mechanisms make significant contributions. 1 Therapies designed to treat IGT aim to prevent diabetes onset. The most common therapy is metformin or acarbose.…”

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confidence: 99%