Neuroendocrine Tumors of the Colon and Rectum

Ford, Molly M.

doi:10.1097/dcr.0000000000000917

Cited by 16 publications

(23 citation statements)

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“…Besides, the patients treated endoscopically were more likely to demonstrate smaller tumors, rectal lesions, no submucosal involvement, and well-differentiated histology. As in previous research, the prognosis was linked to age [28], marital status [29], tumor size [2], tumor site [2], and differentiation grade [1]. Since these covariates might lead to bias that disturbs the comparison of treatment strategies, PSM was employed in this study.…”

Section: Discussionmentioning

confidence: 99%

Endoscopic and Surgical Treatment of T1N0M0 Colorectal Neuroendocrine Tumors: A Population-Based Comparative Study

Zhu

Zhao

et al. 2020

Preprint

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Background: With the rapid advances in endoscopic technology, endoscopic therapy (ET) is increasingly applied to the treatment of small (≤20 mm) colorectal neuroendocrine tumors (NETs). However, long-term data comparing ET and surgery for management of T1N0M0 colorectal NETs are lacking. The purpose of this work was to compare overall survival (OS) and cancer-specific survival (CSS) of such patients with ET or surgery.Methods: Patients with T1N0M0 colorectal NETs were identified within the Surveillance Epidemiology and End Results (SEER) database (2004-2016). Demographics, tumor characteristics, therapeutic methods, and survival were compared. Propensity score matching (PSM) was used 1:3 and among this cohort, Cox proportional hazards regression models were performed to evaluate correlation between treatment and outcomes.Results: Of 4487 patients with T1N0M0 colorectal NETs, 1125 were identified in the matched cohort, among whom 819 (72.8%) underwent ET and 306 (27.2%) underwent surgery. There was no difference in the 5-year and 10-year OS and CSS rates between the 2 treatment modalities. Likewise, analyses stratified by tumor size and site showed that patients did not benefit more from surgery compared with ET. Moreover, multivariate analyses found no significant differences in OS [Hazard Ratio (HR) = 0.857, 95% Confidence Interval (CI): 0.513–1.431, P = 0.555] and CSS (HR = 0.925, 95% CI: 0.282–3.040, P = 0.898) between the 2 groups. Similar results were observed when comparisons were limited to patients with different tumor size and site.Conclusions: In this population-based study, patients treated endoscopically had comparable long-term survival compared with those treated surgically, which demonstrates ET as an alternative to surgery in T1N0M0 colorectal NETs.

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Section: Discussionmentioning

confidence: 99%

Endoscopic and Surgical Treatment of T1N0M0 Colorectal Neuroendocrine Tumors: A Population-Based Comparative Study

Zhu

Zhao

et al. 2020

Preprint

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“…The incidence of these tumors continues to increase, and rectal NET showed the largest increase in recent years [2,3]. Rectal NET is known to have a better prognosis than NET of the small bowel, colon, and other sites of the body [2,4,5]. In particular, a rectal NET of a size less than 10 mm is considered an indolent lesion and is typically treated with endoscopic resection [6].…”

Section: Introductionmentioning

confidence: 99%

“…Factors known to date include tumor size, tumor depth, atypical endoscopic features, lymphovascular invasion, venous invasion, mitotic count, Ki-67 index, tumor grade, and muscularis layer invasion [3,[8][9][10][11]. However, due to inconsistency among guidelines and studies, there is a confusion about the determination of appropriate treatment methods using those predicting factors [1,2,[4][5][6]. Furthermore, only a limited number of studies on 10-20 mm sized rectal NET are available.…”

Section: Introductionmentioning

confidence: 99%

Predicting the factors for metastasis and determining treatment strategy in patients with 10–20 mm sized rectal neuroendocrine tumor

Park¹,

Cho²,

Son³

et al. 2020

Preprint

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Background: Rectal neuroendocrine tumor (NET) smaller than 10 mm is typically treated with endoscopic resection. Rectal NET larger than 20 mm should be treated with radical surgical resection. However, proper treatment for 10 - 20 mm sized rectal NET is controversial. The purpose of this study was to investigate the appropriate treatment strategy for 10-20 mm sized rectal NET by verifying factors that can predict metastasis.Methods: A total of 23 patients with 10–20 mm sized NET who were treated at Pusan National University Yangsan Hospital from January 2009 to February 2020 were included. The patients were divided into metastasis group and non-metastasis group and their respective data were analyzed.Results: Six patients had metastasis (26.1%) while 17 patients had no metastasis (73.9%). Tumor size in endorectal ultrasound (EUS) was significantly larger in the metastatic group than in the non-metastatic group (p = 0.036), however pathological tumor size did not show significant difference (p = 0.087). The rate of involvement of muscularis propria was 50% in the metastatic group, which was significantly higher than that in the non-metastatic group (p = 0.040). Lymph node enlargement was observed in a single patient (16.7%) in the metastatic group for each of EUS and computed tomography (CT) imaging. Ki-67 index in the metastatic group was higher than in the non-metastatic group. The two groups also showed a significant difference in the proportion of patients with tumor grade 2 (66.7% vs. 5.9%, p = 0.008). In multivariate analysis, tumor grade was the only independent metastasis-predicting factor (p = 0.010). Conclusions: EUS should be performed to evaluate tumor size, and muscularis propria involvement along with CT imaging to check lymph node enlargement before the treatment of 10–20 mm sized rectal NET. If endoscopic resection was performed, tumor grade should be the most important factor to determine whether additional radical resection is necessary.

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“…The incidence of these tumors is on the rise, and case of rectal NETs showed the largest increase in recent years [2,3]. Rectal NETs are known to have a better prognosis than NETs of the small bowel, colon, and other sites of the body [2,4,5]. In particular, a rectal NET <10 mm is considered an indolent lesion and is typically treated with endoscopic resection [6].…”

Section: Introductionmentioning

confidence: 99%

“…To date, the known factors are the tumor size, tumor depth, atypical endoscopic features, lymphovascular invasion, perineural invasion, mitotic count, Ki-67 index, tumor grade, and muscularis layer invasion [3,[8][9][10][11]. However, due to inconsistency among the guidelines and studies, there is confusion regarding the determination of the appropriate treatment methods using those predicting factors [1,2,[4][5][6]. Furthermore, only a limited number of studies on 10-20-mm sized rectal NETs is available.…”

Section: Introductionmentioning

confidence: 99%

Factors predicting metastasis in patients with 10–20-mm sized rectal neuroendocrine tumor 

Park¹,

Cho²,

Son³

et al. 2020

Preprint

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Background: Rectal neuroendocrine tumors (NET) <10 mm are typically treated with endoscopic resection, while those >20 mm should be treated with radical surgical resection. However, the proper treatment methodology for 10-20-mm sized rectal NETs remains controversial. The purpose of this study was to investigate the appropriate treatment strategy for 10-20-mm sized rectal NETs by verifying factors that can predict metastasis.Methods: A total of 24 patients with 10–20-mm sized NETs who were treated at Pusan National University Yangsan Hospital from January 2009 to September 2020 were included. The patients were divided into the metastasis and non-metastasis groups, and their respective data were analyzed.Results: Seven patients had metastasis (29.2%) while 17 patients had no metastasis (70.8%). The tumor size, based on the endorectal ultrasound (EUS) findings, was significantly larger in the metastatic than in the non-metastatic group (14.4 vs. 10.2 mm, p = 0.029); however, the pathological tumor size did not show significant differences (13.3 vs. 11.8 mm, p = 0.065). Lymph node enlargement was observed in a single patient (14.3%) in the metastatic group, based on EUS and computed tomography (CT) imaging findings. The mitotic count (p = 0.017) and Ki-67 index (p = 0.014) were significantly higher in the metastatic group than in the non-metastatic group. The two groups also showed a significant difference in the proportion of patients with tumor grade 2 (71.4% vs. 5.9%, p = 0.003). In multivariate analysis, the tumor grade was the only independent metastasis-predicting factor (odds ratio = 49.25; 95% confidence interval = 2.55–950.83; p = 0.010). Conclusions: Regarding the treatment of 10–20-mm sized rectal NETs, tumor grade 2 should be the most important factor to determine whether additional radical resection is necessary.

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Neuroendocrine Tumors of the Colon and Rectum

Cited by 16 publications

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Endoscopic and Surgical Treatment of T1N0M0 Colorectal Neuroendocrine Tumors: A Population-Based Comparative Study

Endoscopic and Surgical Treatment of T1N0M0 Colorectal Neuroendocrine Tumors: A Population-Based Comparative Study

Predicting the factors for metastasis and determining treatment strategy in patients with 10–20 mm sized rectal neuroendocrine tumor

Factors predicting metastasis in patients with 10–20-mm sized rectal neuroendocrine tumor

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Neuroendocrine Tumors of the Colon and Rectum

Cited by 16 publications

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Endoscopic and Surgical Treatment of T1N0M0 Colorectal Neuroendocrine Tumors: A Population-Based Comparative Study

Endoscopic and Surgical Treatment of T1N0M0 Colorectal Neuroendocrine Tumors: A Population-Based Comparative Study

Predicting the factors for metastasis and determining treatment strategy in patients with 10–20 mm sized rectal neuroendocrine tumor

Factors predicting metastasis in patients with 10–20-mm sized rectal neuroendocrine tumor&nbsp;

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Factors predicting metastasis in patients with 10–20-mm sized rectal neuroendocrine tumor