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Surveillance Strategy for Rectal Neuroendocrine Tumors According to Recurrence Risk Stratification

 Dong Hyun Kim  ;  Jin Ha Lee  ;  Yoon Jin Cha  ;  Soo Jung Park  ;  Jae Hee Cheon  ;  Tae Il Kim  ;  Hoguen Kim  ;  Won Ho Kim  ;  Sung Pil Hong 
 DIGESTIVE DISEASES AND SCIENCES, Vol.59(4) : 850-856, 2014 
Journal Title
Issue Date
Adult ; Aged ; Carcinoma, Neuroendocrine/epidemiology* ; Carcinoma, Neuroendocrine/pathology ; Carcinoma, Neuroendocrine/surgery ; Colonoscopy* ; Continuity of Patient Care ; Female ; Humans ; Kaplan-Meier Estimate ; Male ; Middle Aged ; Neoplasm Recurrence, Local/epidemiology* ; Population Surveillance/methods ; Prognosis ; Rectal Neoplasms/epidemiology* ; Rectal Neoplasms/pathology ; Rectal Neoplasms/surgery ; Risk Assessment ; Risk Factors
Rectal neuroendocrine tumor ; Long-term outcome ; Surveillance ; Recurrence
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 1-30) 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.
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1. College of Medicine (의과대학) > Dept. of Pathology (병리학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Dong Hyun(김동현)
Kim, Won Ho(김원호) ORCID logo https://orcid.org/0000-0002-5682-9972
Kim, Tae Il(김태일) ORCID logo https://orcid.org/0000-0003-4807-890X
Kim, Hogeun(김호근)
Park, Soo Jung(박수정)
Cha, Yoon Jin(차윤진) ORCID logo https://orcid.org/0000-0002-5967-4064
Cheon, Jae Hee(천재희) ORCID logo https://orcid.org/0000-0002-2282-8904
Hong, Sung Pil(홍성필)
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