Chang Mo Moon1, Kyu Chan Huh2, Sung-Ae Jung1, Dong Il Park3, Won Hee Kim4, Hye Mi Jung5, Seong-Joon Koh6, Jin-Oh Kim7, Yunho Jung8, Kyeong Ok Kim9, Jong Wook Kim10, Dong-Hoon Yang11, Jeong Eun Shin12, Sung Jae Shin13, Eun Soo Kim14, Young-Eun Joo15. 1. Department of Internal Medicine, School of Medicine, Ewha Womans University, Seoul, South Korea. 2. Department of Internal Medicine, Konyang University College of Medicine, Konyang University Hospital, Daejeon, South Korea. 3. Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea. 4. Digestive Disease Center, CHA Bundang Medical Center, CHA University, Seongnam, South Korea. 5. Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea. 6. Department of Internal Medicine, Seoul National University College of Medicine, Boramae Medical Center, Seoul, South Korea. 7. Department of Internal Medicine, Soonchunhyang University College of Medicine, Seoul Hospital, Seoul, South Korea. 8. Department of Internal Medicine, Soonchunhyang University College of Medicine, Cheonan Hospital, Cheonan, South Korea. 9. Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, South Korea. 10. Department of Internal Medicine, Inje University College of Medicine, Ilsan Paik Hospital, Goyang, South Korea. 11. Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea. 12. Department of Internal Medicine, Dankook University College of Medicine, Cheonan, South Korea. 13. Department of Internal Medicine, Ajou University School of Medicine, Suwon, South Korea. 14. Department of Internal Medicine, Keimyung University School of Medicine, Daegu, South Korea. 15. Department of Internal Medicine, Chonnam National University Medical School, Gwangju, South Korea.
Abstract
OBJECTIVES: With advances in diagnostic endoscopy, the detection of rectal neuroendocrine tumors (NETs) has increased. However, clinical outcomes, especially after endoscopic treatment, are still unclear. The aim of this study was to determine the long-term clinical outcomes of endoscopically resected rectal NETs according to the pathologic status after initial resection. METHODS: In this large, multicenter, retrospective cohort study, we analyzed the medical records of patients who underwent endoscopic resection of rectal NETs and were followed for ≥24 months at 16 university hospitals. The outcomes of interest were local or distant recurrence and metachronous lesions. RESULTS: On the pathologic assessment of 407 patients, the resection margin status was positive in 76 (18.7%) and indeterminate in 72 (17.7%) patients. Patients whose rectal NETs were diagnosed or suspected as NETs before resection showed a much higher complete resection rate than those whose tumors were resected as polyps and then diagnosed (P<0.001). Fourteen patients received salvage treatment at 1.9±2.8 months after initial treatment. During a median follow-up period of 45.0 months, local recurrence occurred in 3 (0.74%) patients, but there was no recurrence in the lymph nodes or distant organs. Metachronous rectal NETs were diagnosed in 3 (0.74%) patients. According to the pathologic status after initial resection, local recurrence and metachronous lesions occurred in 1 (0.4%) and 2 (0.8%) patients, respectively, in the pathologic tumor-free group, whereas they occurred in 2 (1.4%) and 1 (0.7%) patients, respectively, in the indeterminate group. CONCLUSIONS: Considering the long-term prognosis including that for recurrences or metachronous lesions, endoscopic resection is an efficient and a safe modality for the treatment of rectal NETs. This treatment may result in favorable clinical outcomes in patients with tumors of indeterminate pathology, as well as in pathologic tumor-free cases after initial resection.
OBJECTIVES: With advances in diagnostic endoscopy, the detection of rectal neuroendocrine tumors (NETs) has increased. However, clinical outcomes, especially after endoscopic treatment, are still unclear. The aim of this study was to determine the long-term clinical outcomes of endoscopically resected rectal NETs according to the pathologic status after initial resection. METHODS: In this large, multicenter, retrospective cohort study, we analyzed the medical records of patients who underwent endoscopic resection of rectal NETs and were followed for ≥24 months at 16 university hospitals. The outcomes of interest were local or distant recurrence and metachronous lesions. RESULTS: On the pathologic assessment of 407 patients, the resection margin status was positive in 76 (18.7%) and indeterminate in 72 (17.7%) patients. Patients whose rectal NETs were diagnosed or suspected as NETs before resection showed a much higher complete resection rate than those whose tumors were resected as polyps and then diagnosed (P<0.001). Fourteen patients received salvage treatment at 1.9±2.8 months after initial treatment. During a median follow-up period of 45.0 months, local recurrence occurred in 3 (0.74%) patients, but there was no recurrence in the lymph nodes or distant organs. Metachronous rectal NETs were diagnosed in 3 (0.74%) patients. According to the pathologic status after initial resection, local recurrence and metachronous lesions occurred in 1 (0.4%) and 2 (0.8%) patients, respectively, in the pathologic tumor-free group, whereas they occurred in 2 (1.4%) and 1 (0.7%) patients, respectively, in the indeterminate group. CONCLUSIONS: Considering the long-term prognosis including that for recurrences or metachronous lesions, endoscopic resection is an efficient and a safe modality for the treatment of rectal NETs. This treatment may result in favorable clinical outcomes in patients with tumors of indeterminate pathology, as well as in pathologic tumor-free cases after initial resection.
Authors: Chang Mo Moon; Jae Hee Cheon; Eun Hee Choi; Eun Soo Kim; Jae Jun Park; Song Yi Han; Duk Hwan Kim; Tae Il Kim; Won Ho Kim Journal: J Clin Gastroenterol Date: 2010-08 Impact factor: 3.062
Authors: Sang Heon Lee; Seun Ja Park; Hyung Hun Kim; Kyung Sun Ok; Ji Hyun Kim; Sam Ryong Jee; Sang Young Seol; Bo Mi Kim Journal: Clin Endosc Date: 2012-03-31
Authors: James C Yao; Manal Hassan; Alexandria Phan; Cecile Dagohoy; Colleen Leary; Jeannette E Mares; Eddie K Abdalla; Jason B Fleming; Jean-Nicolas Vauthey; Asif Rashid; Douglas B Evans Journal: J Clin Oncol Date: 2008-06-20 Impact factor: 44.544
Authors: Jae Hwang Cha; Da Hyun Jung; Jie-Hyun Kim; Young Hoon Youn; Hyojin Park; Jae Jun Park; Yoo Jin Um; Soo Jung Park; Jae Hee Cheon; Tae Il Kim; Won Ho Kim; Hyun Jung Lee Journal: Sci Rep Date: 2019-03-20 Impact factor: 4.379