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Recurrence pattern and surveillance strategy for rectal neuroendocrine tumors after endoscopic resection
Author(s) -
Chung Hye Gyo,
Goh Myung Ji,
Kim Eun Ran,
Hong Sung Noh,
Kim Tae Jun,
Chang Dong Kyung,
Kim YoungHo
Publication year - 2021
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/jgh.15231
Subject(s) - medicine , neuroendocrine tumors , hazard ratio , confidence interval , metastasis , rectum , radiology , colorectal cancer , surgery , cancer
Abstract Background and Aim Endoscopic resection is highly effective treatment option for rectal neuroendocrine tumors (NETs) as they usually present as small localized tumors. However, there are no well‐established surveillance strategies following endoscopic resection. We established our own protocol for the surveillance of rectal NETs after endoscopic resection since 2013. This study aimed to assess the outcome and to optimize the surveillance strategies after endoscopic resection. Methods We retrospectively analyzed the data of patients with endoscopically treated rectal NETs between January 2013 and April 2018 at Samsung Medical Center. We analyzed 337 patients with a median follow‐up duration of 35.0 months (min–max: 12.0–88.3). Results A total of 329 (97.6%) patients had tumors ≤ 1 cm in size, and eight (2.4%) patients had tumors > 1 cm in diameter. Synchronous rectal NETs were diagnosed in nine (2.7%) patients. Thirteen (3.9%) patients were identified as having positive resection margins. Regardless of the salvage treatment, none of these patients developed recurrence. Metachronous rectal NETs were diagnosed in nine (2.7%) patients. Metachronous lesions were associated with the number of synchronous lesions at initial diagnosis ( P < 0.001, hazard ratio = 1.75, 95% confidence interval = 1.38–2.23). Extracolonic metastasis was not detected in this study. Conclusion Although initial screening for detecting metastatic lesions using computed tomography is recommended, repeated imaging for detecting extracolonic recurrence was not necessary for small non‐metastatic rectal NETs. However, regular endoscopic follow‐up seems reasonable, especially in case of synchronous rectal NETs, for detecting metachronous rectal NETs.