Gabriele Capurso1, Sebastien Gaujoux2, Lorenzo Carlo Pescatori3, Francesco Panzuto3, Yves Panis4, Emanuela Pilozzi5, Benoit Terris6, Louis de Mestier7, Frederic Prat8, Maria Rinzivillo3, Romain Coriat8, Anne Coulevard9, Gianfranco Delle Fave3, Philippe Ruszniewski7. 1. Digestive and Liver Disease Unit, S. Andrea Hospital, ENETs Center of Excellence, Rome, Italy; Pancreato-biliary Endoscopy and EUS Division, Pancreas Translational and Clinical Research Center, ENETs Center of Excellence, San Raffaele Scientific Institute IRCCS, Milan, Italy. Electronic address: capurso.gabriele@hsr.it. 2. Department of Pancreatic, Hepato-biliary and Endocrine Surgery, Cochin Hospital, APHP, Paris, France; Faculté de Médecine Paris Descartes, Université Paris Descartes, Sorbonne Paris Cité, Paris, France. 3. Digestive and Liver Disease Unit, S. Andrea Hospital, ENETs Center of Excellence, Rome, Italy. 4. Department of Colorectal Surgery, Beaujon Hospital, APHP, ENETs Center of Excellence, Clichy, France; University Denis Diderot - Paris VII, Paris, France. 5. Pathology Unit, University Sapienza, S. Andrea Hospital, ENETs Center of Excellence, Rome, Italy. 6. Faculté de Médecine Paris Descartes, Université Paris Descartes, Sorbonne Paris Cité, Paris, France; Department of Pathology, Cochin Hospital, APHP, Paris, France. 7. University Denis Diderot - Paris VII, Paris, France; Department of Gastroenterology and Pancreatology, Beaujon Hospital, APHP, ENETs Center of Excellence, Clichy, France. 8. Faculté de Médecine Paris Descartes, Université Paris Descartes, Sorbonne Paris Cité, Paris, France; Department of Gastroenterology, Cochin Hospital, APHP, Paris, France. 9. University Denis Diderot - Paris VII, Paris, France; Department of Gastroenterology, Cochin Hospital, APHP, Paris, France.
Abstract
BACKGROUND: Factors associated with rectal NENs prognosis are poorly investigated. AIM: To evaluate the prognostic role of the ENETs staging and grading systems in rectal NENs. METHODS: Tertiary referral, multicenter, retrospective study. Factors associated with OS and PFS were investigated by Cox-regression analysis, with best size cut-offs calculated by ROC analysis. RESULTS: Of 100 patients (mean age 55, 45% male, mean size 16.2 mm) 62, 5, 10 and 23 were TNM stage 1 to 4, and 63, 15 and 22 were G1, G2 and G3. Primary treatment was endoscopic snare resection in 62%, endoscopic mucosal resection/endoscopic submucosal dissection in 10%, surgery in 20% and medical treatment in 8%. The best size cut-offs to predict OS and PFS were 10 and 12 mm. During a mean follow-up of 40.7 months 12% died and 26% progressed. The 5-year OS and PFS were 79.5% and 65.2%. Stage IV and G3 were associated with worse OS (HR 8.16; p = 0.002; HR 15.57; p = 0.0004) and PFS (HR 14.26 p < 0.0001; HR 6.42; p = 0.0007). CONCLUSION: Both staging and grading accurately predict rectal NENs prognosis. Size alone has limited accuracy as 26% of patients with stage IV and 16% with G3 have a primary tumour≤10 mm.
BACKGROUND: Factors associated with rectal NENs prognosis are poorly investigated. AIM: To evaluate the prognostic role of the ENETs staging and grading systems in rectal NENs. METHODS: Tertiary referral, multicenter, retrospective study. Factors associated with OS and PFS were investigated by Cox-regression analysis, with best size cut-offs calculated by ROC analysis. RESULTS: Of 100 patients (mean age 55, 45% male, mean size 16.2 mm) 62, 5, 10 and 23 were TNM stage 1 to 4, and 63, 15 and 22 were G1, G2 and G3. Primary treatment was endoscopic snare resection in 62%, endoscopic mucosal resection/endoscopic submucosal dissection in 10%, surgery in 20% and medical treatment in 8%. The best size cut-offs to predict OS and PFS were 10 and 12 mm. During a mean follow-up of 40.7 months 12% died and 26% progressed. The 5-year OS and PFS were 79.5% and 65.2%. Stage IV and G3 were associated with worse OS (HR 8.16; p = 0.002; HR 15.57; p = 0.0004) and PFS (HR 14.26 p < 0.0001; HR 6.42; p = 0.0007). CONCLUSION: Both staging and grading accurately predict rectal NENs prognosis. Size alone has limited accuracy as 26% of patients with stage IV and 16% with G3 have a primary tumour≤10 mm.
Authors: Camilla Gallo; Roberta Elisa Rossi; Federica Cavalcoli; Federico Barbaro; Ivo Boškoski; Pietro Invernizzi; Sara Massironi Journal: World J Gastroenterol Date: 2022-03-21 Impact factor: 5.742
Authors: Markus Brand; Stanislaus Reimer; Joachim Reibetanz; Sven Flemming; Marko Kornmann; Alexander Meining Journal: Int J Colorectal Dis Date: 2020-11-19 Impact factor: 2.571