Treatment strategy for rectal carcinoids: A clinicopathological analysis of 229 cases at a single cancer institution

Abstract

Venous invasion as well as tumor size and lymphatic invasion indicates high malignant potential to metastasize to lymph node and would provide useful information in considering the addition of radical surgery. Postoperative pathological examinations of specimens obtained by local resection are very important to avoid underestimation.

Clinical Outcomes of Patients with Small Rectal Neuroendocrine Tumors Treated Using Endoscopic Submucosal Resection with a Ligation Device

“…For patients with rectal NETs, predictors of nodal or distant metastasis have been studied in previous studies. Also, tumor size and WHO grade [21][22][23], venous and lymphatic invasions have been considered as risk factors of metastatic disease [24,25]. Although additional surgery should be considered in patients with rectal NETs harboring lymphovascular invasion, this approach needs further validation because the reported prevalence of lymphovascular invasion ranges widely from approximately 1% to a little less than 60% [14,26].…”

Clinical impact of endoscopic ultrasonography for small rectal neuroendocrine tumors

“…Historically, endoscopic resection has been considered curative in cases of rectal NETs ≤10 mm in size (1,15). However, several studies and case reports have reported metastasis of small rectal NETs (16)(17)(18)(19). We performed EUS for all 76 lesions before endoscopic resection.…”

Excellent prognosis following endoscopic resection of patients with rectal neuroendocrine tumors despite the frequent presence of lymphovascular invasion

“…Based on the fact that rectal NETs that are small and confined to the submucosal layer rarely metastasize, these lesions are usually treated by local excision, including ER [2,3,[8][9][10][11][12][13][14]. However, small rectal NETs, including those less than 10 mm in size, can also metastasize [8][9][10][11][12][14][15][16][17]; therefore, identification of additional clinicopathological factors that could influence the risk of metastasis may help determine the most appropriate management.…”

“…Based on the fact that rectal NETs that are small and confined to the submucosal layer rarely metastasize, these lesions are usually treated by local excision, including ER [2,3,[8][9][10][11][12][13][14]. However, small rectal NETs, including those less than 10 mm in size, can also metastasize [8][9][10][11][12][14][15][16][17]; therefore, identification of additional clinicopathological factors that could influence the risk of metastasis may help determine the most appropriate management. To date, in addition to tumor size and depth of invasion, several other risk factors for metastasis have also been reported, including the patient age, presence of lymphovascular invasion, tumor proliferative activity, presence of perineural invasion, and presence of atypical surface characteristics (depression and ulceration) [9][10][11][12][13][14][18][19][20][21][22].…”