Endoscopically removed rectal NETs: a nationwide cohort study
| Autor: | Teaco Kuiper, N. van Lelyveld, M. G. H. van Oijen, Heinz-Josef Klümpen, M.L.F. van Velthuysen, M. E. van Leerdam, F. D. Vleggaar |
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| Přispěvatelé: | Oncology, APH - Methodology, APH - Quality of Care, CCA - Cancer Treatment and Quality of Life, Pathology |
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
medicine.diagnostic_test business.industry Gastroenterology Rectum Colonoscopy Guideline Hepatology Surgery 03 medical and health sciences 0302 clinical medicine medicine.anatomical_structure Median follow-up Endoscopic resection Recurrence 030220 oncology & carcinogenesis Internal medicine Neuroendocrine tumour medicine Resection margin 030211 gastroenterology & hepatology business Lymph node Cohort study |
| Zdroj: | International Journal of Colorectal Disease. SPRINGER International Journal of Colorectal Disease International journal of colorectal disease, 36(3), 535-541. Springer Verlag International Journal of Colorectal Disease, 36(3), 535-541. Springer-Verlag |
| ISSN: | 0179-1958 |
| Popis: | Purpose: Rectal neuroendocrine tumours (NETs) often present as an incidental finding during colonoscopy. Complete endoscopic resection of low-grade NETs up to 10 mm is considered safe. Whether this is also safe for NETs up to 20 mm is unclear. We performed a nationwide study to determine the risk of lymph node and distant metastases in endoscopically removed NETs. Methods: All endoscopically removed rectal NETs between 1990 and 2010 were identified using the national pathology database (PALGA). Each NET was stratified according to size, grade and resection margin. Follow-up was until February 2016. Results: Between 1990 and 2010, a total of 310 NETs smaller than 20 mm were endoscopically removed. Mean size of NETs was 7.4 mm (SD 3.5). In 49% of NETs (n = 153), no grade (G) could be assessed from the pathology report, 1% was G2 (n = 3), and the remaining NETs were G1. Median follow up was 11.6 years (range 4.9–26.0). During follow-up, 30 patients underwent surgical resection. Lymph node or distant metastasis was seen in 3 patients (1%) which all had a grade 2 NET. Mean time from endoscopic resection to diagnosis of metastases was 6.1 years (95% CI 2.9–9.2). Conclusion: No lymph node or distant metastases were seen in endoscopically removed G1 NETs up to 20 mm during the long follow-up of this nationwide study. This adds evidence to the ENET guideline that endoscopic resection of G1 NETs up to 20 mm appears to be safe. |
| Databáze: | OpenAIRE |
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