Surveillance Strategy for Rectal Neuroendocrine Tumors According to Recurrence Risk Stratification

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• 作者：Dong Hyun Kim (1)
  Jin Ha Lee (1)
  Yoon Jin Cha (2)
  Soo Jung Park (1)
  Jae Hee Cheon (1)
  Tae Il Kim (1)
  Hoguen Kim (2)
  Won Ho Kim (1)
  Sung Pil Hong (1)
  
• 关键词：Rectal neuroendocrine tumor ; Long ; term outcome ; Surveillance ; Recurrence
• 刊名：Digestive Diseases and Sciences
• 出版年：2014
• 出版时间：April 2014
• 年：2014
• 卷：59
• 期：4
• 页码：850-856
• 全文大小：356 KB
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• 作者单位：Dong Hyun Kim (1)
  Jin Ha Lee (1)
  Yoon Jin Cha (2)
  Soo Jung Park (1)
  Jae Hee Cheon (1)
  Tae Il Kim (1)
  Hoguen Kim (2)
  Won Ho Kim (1)
  Sung Pil Hong (1)
  
  1. Department of Internal Medicine, Institute of Gastroenterology, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 120-752, South Korea
  2. Department of Pathology, Yonsei University College of Medicine, Seoul, South Korea
  
• ISSN：1573-2568

文摘

Background/Aim Rectal neuroendocrine tumors (NETs) have been increasing in incidence. However, the recommendations for disease surveillance after tumor resection have not been well established. We evaluated the long-term outcomes of rectal NETs and surveillance strategies according to recurrence risk stratification. Methods From January 2000 to July 2011, 188 patients diagnosed with rectal NETs were included in this study. Patient characteristics, treatment methods, recurrence rates, risk factors of recurrence, and surveillance schedules were analyzed. Results The male-to-female ratio was 1.29:1 and the mean age at diagnosis was 50.6?years. The mean tumor size was 6.5 (range 1-0) mm. A total of 144 patients (76.6?%) were treated with endoscopic resection, and 44 patients (23.4?%) were treated with surgical resection as the initial treatment. During the follow-up period, ten patients (5.3?%) had disease recurrence, including one case of local recurrence and nine cases of recurrence at a distant site. Tumor size of >10?mm, invasion of the muscularis propria, increased mitotic index, lymphovascular invasion, and regional lymph node metastases were statistically significant predictors of recurrence by univariate analysis. Among the 152 patients without risk factors of recurrence, only one patient who underwent transanal resection had a local recurrence at 15?months after surgery. Conclusion Our patients with rectal NETs showed favorable clinical outcomes and had a low rate of recurrence. Intensive surveillance with endoscopy or imaging study may not be required in patients without risk factors for recurrence.