Recurrence and Survival of Neuroendocrine Neoplasms of the Rectum: Single-Center Experience
| Autor: | Ana Sofia Ore, Thomas E. Cataldo, Israel A Gaytan-Fuentes, Alessandra Storino, Evangelos Messaris, Daniel J. Wong, Anne C. Fabrizio |
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| Rok vydání: | 2020 |
| Předmět: |
Adult
medicine.medical_specialty medicine.medical_treatment Rectum Endoscopic mucosal resection Neuroendocrine tumors Single Center 03 medical and health sciences 0302 clinical medicine medicine Humans Neoplasm Staging Retrospective Studies Transanal Excision Abdominoperineal resection business.industry Rectal Neoplasms Gastroenterology Colonoscopy medicine.disease Polypectomy Surgery Neuroendocrine Tumors medicine.anatomical_structure Treatment Outcome 030220 oncology & carcinogenesis Localized disease 030211 gastroenterology & hepatology Neoplasm Recurrence Local business |
| Zdroj: | Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract. 25(9) |
| ISSN: | 1873-4626 |
| Popis: | In 2010, the World Health Organization proposed that rectal neuroendocrine neoplasms (NENs) be considered malignant. We hypothesized that patients with small, low-grade, locally excised tumors have a low risk of recurrence and death. Retrospective review of institutional database 2006–2017 including consecutive adults with newly diagnosed rectum NENs. Outcome measures included risk of recurrence and 5-year overall survival. A total of 122 patients were diagnosed with rectal NENs. Most patients were asymptomatic and diagnosed during screening colonoscopy (80, 66.1%), had small tumors (median 0.6 cm, IQR 0.5–1) with intact muscularis propria on EUS (62/65, 95.4%), and were low grade (2017 WHO grades 1–2, n = 116, 95.1%). Lymph node and distant metastasis were found in 4 (3.3%) and 4 (3.3%) of patients, respectively. Patients were treated with local excision in 93.4% of cases with polypectomy (52, 42.6%), endoscopic mucosal resection (48, 39.3%), and transanal excision (14, 11.5%). Three patients (2.5%) required abdominoperineal resection or low anterior resection, and five patients (4.1%) received adjuvant chemotherapy. Of 87 patients surveilled, 4 (4.6%) recurred at a median time of 1 year (IQR 0.6–8). Death from neuroendocrine neoplasms occurred in 5 (4.1%) patients, all with lymph node (1/4) or metastatic disease (4/5) on presentation. Median time to death from NEN was 0.8 years (0.7–2.4). Overall 5-year survival for patients with localized disease was 98.2% (95% CI 93–99.5, Fig. 1). Patients with small, low grade rectal NENs treated with local excision have excellent oncologic outcomes. |
| Databáze: | OpenAIRE |
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