Outcomes of Rectal Neuroendocrine Tumors Having Both Diameter of Less than 1 cm and Lymphovascular Involvement

Shimizuguchi Ryoko, Koizumi Koichi, Horiguchi Sinichiro, Takao Akinari, Shibata Satomi, Natsume Soichiro, Takao Misato, Nakano Daisuke, Yamaguchi Tatsuro, Kawai Kazushige, Iizuka Toshiro

doi:10.3862/jcoloproctology.77.77

<p>In the case of neuroendocrine tumors (NETs), additional resection should be considered if the pathological examination shows positive for lymphovascular invasion, but there is not enough evidence on the long-term prognosis. Among patients with a NET G1 < 1 cm in diameter which was confined to the submucosal layer and treated endoscopically at our hospital between January 2005 and December 2021, 44 (27.8%) with vascular invasion were enrolled to investigate the lymph node/distant metastasis rate and the recurrence/mortality rate. Twelve patients were placed in the additional resection group (two with lymph node metastasis), and 32 were placed in the no additional treatment group (five with death from other causes). No distant metastasis, recurrence, or current death was observed in either group. There was also no recurrence of or death due to primary tumor among the patients with positive vascular invasion after endoscopic treatment of a NET G1 tumor < 1 cm in diameter. Colostomy was required in 75% of the patients who underwent an additional resection. Moreover, there were some cases of lymph node metastasis. The decision to perform an additional surgical resection should take into account the patient's wishes in terms of quality of life and the recurrence rate. How to stratify patients for follow-up remains an issue for future study.</p>

Outcomes of Rectal Neuroendocrine Tumors Having Both Diameter of Less than 1 cm and Lymphovascular Involvement

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