Assessing risk stratification in long-term outcomes of rectal neuroendocrine tumors following endoscopic resection: a multicenter retrospective study

Hyun Jin Lee, Yun Seo, Chang Kyo Oh, Ji Min Lee, Hyun Ho Choi, Tae Geun Gweon, Sung Hak Lee, Dae Young Cheung, Jin Il Kim, Soo Heon Park, Han Hee Lee

Research output: Contribution to journalArticlepeer-review

2 Scopus citations

Abstract

Objectives: While endoscopic resection of rectal neuroendocrine tumors (NETs) has significantly increased, long-term data on risk factors for recurrence are still lacking. Our aim is to analyze the long-term outcomes of patients with rectal NETs after endoscopic resection through risk stratification. Methods: In this multicenter retrospective study, we included patients who underwent endoscopic resection of rectal NETs from 2009 to 2018 and were followed for ≥12 months at five university hospitals. We classified the patients into three risk groups according to the clinicopathological status of the rectal neuroendocrine tumors: low, indeterminate, and high. The high-risk group was defined if the tumors have any of the followings: size ≥ 10 mm, lymphovascular invasion, muscularis propria or deeper invasion, positive resection margins, or mitotic count ≥2/10. Results: A total of 346 patients were included, with 144 (41.6%), 121 (35.0%), and 81 (23.4%) classified into the low-, indeterminate-, and high-risk groups, respectively. Among the high-risk group, seven patients (8.6%) received salvage treatment 28 (27–67) days after the initial endoscopic resection, with no reported extracolonic recurrence. Throughout the follow-up period, 1.1% (4/346) of patients experienced extracolonic recurrences at 56.5 (54–73) months after the initial endoscopic resection. Three of these patients (75%) were in the high-risk group and did not undergo salvage treatment. The risk of extracolonic recurrence was significantly higher in the high-risk group compared to the other groups (p = 0.039). Conclusion: Physicians should be concerned about the possibility of metastasis during long-term follow-up of high-risk patients and consider salvage treatment.

Original languageEnglish
Pages (from-to)868-874
Number of pages7
JournalScandinavian Journal of Gastroenterology
Volume59
Issue number7
DOIs
StatePublished - 2024

Bibliographical note

Publisher Copyright:
© 2024 Informa UK Limited, trading as Taylor & Francis Group.

Keywords

  • Neuroendocrine tumor, rectum
  • endoscopic mucosal resection
  • prognosis
  • risk factors

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