Clinical outcomes of endoscopic mucosal resection for rectal neuroendocrine tumor
Abstract Background The incidence of rectal neuroendocrine tumors (NETs) is rapidly increasing because of the frequent use of endoscopic screening for colorectal cancers. However, the clinical outcomes of endoscopic resection for rectal NETs are still unclear. The aim of this study was to assess the...
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| Format: | Article |
| Language: | English |
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BMC
2018-06-01
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| Series: | BMC Gastroenterology |
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| Online Access: | http://link.springer.com/article/10.1186/s12876-018-0806-y |
| _version_ | 1818214051690315776 |
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| author | Jihye Kim Jee Hyun Kim Joo Young Lee Jaeyoung Chun Jong Pil Im Joo Sung Kim |
| author_facet | Jihye Kim Jee Hyun Kim Joo Young Lee Jaeyoung Chun Jong Pil Im Joo Sung Kim |
| author_sort | Jihye Kim |
| collection | DOAJ |
| description | Abstract Background The incidence of rectal neuroendocrine tumors (NETs) is rapidly increasing because of the frequent use of endoscopic screening for colorectal cancers. However, the clinical outcomes of endoscopic resection for rectal NETs are still unclear. The aim of this study was to assess the rates of histologically complete resection (H-CR) and recurrence after endoscopic mucosal resection (EMR) for rectal NETs. Methods A retrospective analysis was performed on patients who underwent EMR for rectal NETs between January 2002 and March 2015 at Seoul National University Hospital. Primary outcomes were H-CR and recurrence rates after endoscopic resection. H-CR was defined as the absence of tumor invasion in the lateral and deep margins of resected specimens. Results Among 277 patients, 243 (88%) were treated with conventional EMR, 23 (8%) with EMR using a dual-channel endoscope, and 11 (4%) with EMR after precutting. The median tumor size was 4.96 mm (range, 1–22) in diameter, and 264 (95%) lesions were confined to the mucosa and submucosal layer. The en-bloc resection rate was 99% and all patients achieved endoscopically complete resection. The H-CR rates were 75, 74, and 73% for conventional EMR, EMR using a dual-channel endoscope, and EMR after precutting, respectively. Multivariate analysis showed that H-CR was associated with tumor size regardless of endoscopic treatment modalities (p = 0.023). Of the 277 patients, 183 (66%) underwent at least 1 endoscopic follow-up. Three (2%) of these 183 patients had tumor recurrence, which was diagnosed at a median of 62.5 months (range 19–98) after endoscopic resection. There was 1 case of disease-related death, which occurred 167 months after endoscopic treatment because of bone marrow failure that resulted from tumor metastasis. Conclusions Although the en-bloc resection rate was 99% in rectal NETs, H-CR rates were 72–74% for various EMR procedures. H-CR may be associated with tumor size regardless of endoscopic treatment modalities. |
| first_indexed | 2024-12-12T06:14:02Z |
| format | Article |
| id | doaj.art-afecbeda4fe14429a5a61a406268000b |
| institution | Directory Open Access Journal |
| issn | 1471-230X |
| language | English |
| last_indexed | 2024-12-12T06:14:02Z |
| publishDate | 2018-06-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Gastroenterology |
| spelling | doaj.art-afecbeda4fe14429a5a61a406268000b2022-12-22T00:35:04ZengBMCBMC Gastroenterology1471-230X2018-06-011811910.1186/s12876-018-0806-yClinical outcomes of endoscopic mucosal resection for rectal neuroendocrine tumorJihye Kim0Jee Hyun Kim1Joo Young Lee2Jaeyoung Chun3Jong Pil Im4Joo Sung Kim5Department of Internal Medicine and Liver Research Institute, Seoul National University College of MedicineDepartment of Internal Medicine, Seoul National University Boramae Hospital, Seoul National University College of MedicineDepartment of Internal Medicine and Liver Research Institute, Seoul National University College of MedicineDepartment of Internal Medicine and Liver Research Institute, Seoul National University College of MedicineDepartment of Internal Medicine and Liver Research Institute, Seoul National University College of MedicineDepartment of Internal Medicine and Liver Research Institute, Seoul National University College of MedicineAbstract Background The incidence of rectal neuroendocrine tumors (NETs) is rapidly increasing because of the frequent use of endoscopic screening for colorectal cancers. However, the clinical outcomes of endoscopic resection for rectal NETs are still unclear. The aim of this study was to assess the rates of histologically complete resection (H-CR) and recurrence after endoscopic mucosal resection (EMR) for rectal NETs. Methods A retrospective analysis was performed on patients who underwent EMR for rectal NETs between January 2002 and March 2015 at Seoul National University Hospital. Primary outcomes were H-CR and recurrence rates after endoscopic resection. H-CR was defined as the absence of tumor invasion in the lateral and deep margins of resected specimens. Results Among 277 patients, 243 (88%) were treated with conventional EMR, 23 (8%) with EMR using a dual-channel endoscope, and 11 (4%) with EMR after precutting. The median tumor size was 4.96 mm (range, 1–22) in diameter, and 264 (95%) lesions were confined to the mucosa and submucosal layer. The en-bloc resection rate was 99% and all patients achieved endoscopically complete resection. The H-CR rates were 75, 74, and 73% for conventional EMR, EMR using a dual-channel endoscope, and EMR after precutting, respectively. Multivariate analysis showed that H-CR was associated with tumor size regardless of endoscopic treatment modalities (p = 0.023). Of the 277 patients, 183 (66%) underwent at least 1 endoscopic follow-up. Three (2%) of these 183 patients had tumor recurrence, which was diagnosed at a median of 62.5 months (range 19–98) after endoscopic resection. There was 1 case of disease-related death, which occurred 167 months after endoscopic treatment because of bone marrow failure that resulted from tumor metastasis. Conclusions Although the en-bloc resection rate was 99% in rectal NETs, H-CR rates were 72–74% for various EMR procedures. H-CR may be associated with tumor size regardless of endoscopic treatment modalities.http://link.springer.com/article/10.1186/s12876-018-0806-yNeuroendocrine tumorRectumEndoscopic mucosal resectionEfficacyPrognosis |
| spellingShingle | Jihye Kim Jee Hyun Kim Joo Young Lee Jaeyoung Chun Jong Pil Im Joo Sung Kim Clinical outcomes of endoscopic mucosal resection for rectal neuroendocrine tumor BMC Gastroenterology Neuroendocrine tumor Rectum Endoscopic mucosal resection Efficacy Prognosis |
| title | Clinical outcomes of endoscopic mucosal resection for rectal neuroendocrine tumor |
| title_full | Clinical outcomes of endoscopic mucosal resection for rectal neuroendocrine tumor |
| title_fullStr | Clinical outcomes of endoscopic mucosal resection for rectal neuroendocrine tumor |
| title_full_unstemmed | Clinical outcomes of endoscopic mucosal resection for rectal neuroendocrine tumor |
| title_short | Clinical outcomes of endoscopic mucosal resection for rectal neuroendocrine tumor |
| title_sort | clinical outcomes of endoscopic mucosal resection for rectal neuroendocrine tumor |
| topic | Neuroendocrine tumor Rectum Endoscopic mucosal resection Efficacy Prognosis |
| url | http://link.springer.com/article/10.1186/s12876-018-0806-y |
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