Open AccessRectal neuroendocrine tumors: Current advances in management, treatment, and surveillance
Author(s) -
Camilla Gallo,
Roberta Rossi,
Federica Cavalcoli,
Federico Barbaro,
Ivo Boškoski,
Pietro Invernizzi,
Sara Massironi
Publication year - 2022
Publication title -
world journal of gastroenterology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.427
H-Index - 155
eISSN - 2219-2840
pISSN - 1007-9327
DOI - 10.3748/wjg.v28.i11.1123
Subject(s) - medicine , neuroendocrine tumors , colorectal cancer , endoscopy , incidence (geometry) , muscularis mucosae , rectum , endoscopic treatment , lamina propria , general surgery , cancer , pathology , epithelium , physics , optics
Rectal neuroendocrine neoplasms (r-NENs) are considered among the most frequent digestive NENs, together with small bowel NENs. Their incidence has increased over the past few years, and this is probably due to the widespread use of endoscopic screening for colorectal cancer and the advanced endoscopic procedures available nowadays. According to the current European Neuroendocrine Tumor Society (ENETS) guidelines, well-differentiated r-NENs smaller than 10 mm should be endoscopically removed in view of their low risk of local and distant invasion. R-NENs larger than 20 mm are candidates for surgical resection because of their high risk of distant spreading and the involvement of the muscularis propria. There is an area of uncertainty regarding tumors between 10 and 20 mm, in which the metastatic risk is intermediate and the endoscopic treatment can be challenging. Once removed, the indications for surveillance are scarce and poorly codified by international guidelines, therefore in this paper, a possible algorithm is proposed.