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Article

Evaluation of treatment for rectal neuroendocrine tumors sized under 20 mm in comparison with the WHO 2010 guidelines

  • Authors:
    • Nobuhisa Matsuhashi
    • Takao Takahashi
    • Hiroyuki Tomita
    • Hiroshi Araki
    • Takashi Ibuka
    • Kaori Tanaka
    • Toshiyuki Tanahashi
    • Satoshi Matsui
    • Yoshiyuki Sasaki
    • Yoshihiro Tanaka
    • Naoki Okumura
    • Kazuya Yamaguchi
    • Shinji Osada
    • Kazuhiro Yoshida
  • View Affiliations / Copyright

    Affiliations: Department of Surgical Oncology, Gifu University School of Medicine, Gifu 501‑1194, Japan, Department of Tumor Pathology, Gifu University School of Medicine, Gifu 501‑1194, Japan, Department of Gastroenterology, Gifu University School of Medicine, Gifu 501‑1194, Japan
  • Pages: 476-480
    |
    Published online on: July 18, 2017
       https://doi.org/10.3892/mco.2017.1326
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Abstract

Rectal neuroendocrine tumor (NET) is a relatively rare lesion of the gastrointestinal tract, but the prospective examination with colonofiberoscopy or endoscopic ultrasound has increased the frequency of its detection. It is often difficult to determine the optimal treatment for NETs sized <20 mm in the clinical setting. Other clinicopathological variables are not considered in the current guidelines and staging systems. Although the effects of lymphovascular invasion are not covered by the World Health Organization (WHO) 2010 guidelines or tumor‑node‑metastasis (TNM) staging system, this may be promising for the establishment of improved guidelines and staging systems, particularly for early‑stage colorectal carcinoids. The aim of the present study was to evaluate rectal NETs sized <20 mm in comparison with the WHO 2010 guidelines. Between January 2005 and December 2013, 40 consecutive patients [26 men and 14 women; median age, 59.3 years (range, 34‑81 years)] who underwent endoscopic resection of rectal NETs, and 12 patients undergoing surgical resection of rectal NETs, were enrolled in this retrospective study. The median tumor size was 7.4 mm (range, 3‑15 mm). The locations of the NET were the rectosigmoid colon (n=3), the upper rectum (n=13), and the lower rectum (n=25). The NETs were classified by size as 0‑5 (n=7), 6‑10 (n=29) and 11‑15 mm (n=4). The surgical procedures performed included low anterior resection plus esophagectomy (n=1), laparoscopic low anterior resection (n=7) and laparoscopic intersphincteric resection (n=4). Only 1 patient had lymph node metastasis (tumor sized 6‑10 mm, with lymphovascular invasion). NET recurrence was not detected in any of the patients. According to the WHO guidelines, the tumors were classified as grade (G)1 (n=8), G2 (n=3) and G1/G2 (n=1). The tumor in the patient with lymph node metastasis was G1. NETs sized <10 mm may be curatively treated by endoscopic resection. However, NETs with either lymphovascular invasion or sized >1 cm carry a risk for metastasis equivalent to that of adenocarcinomas. Therefore, it is mandatory to histologically examine lymphovascular invasion in specimens retrieved via endoscopic resection to determine the necessity for further radical surgery with regional lymph node dissection. The treatment of NETs sized <20 mm as presently defined in the WHO 2010 guidelines requires further evaluation.
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Copy and paste a formatted citation
Spandidos Publications style
Matsuhashi N, Takahashi T, Tomita H, Araki H, Ibuka T, Tanaka K, Tanahashi T, Matsui S, Sasaki Y, Tanaka Y, Tanaka Y, et al: Evaluation of treatment for rectal neuroendocrine tumors sized under 20 mm in comparison with the WHO 2010 guidelines. Mol Clin Oncol 7: 476-480, 2017.
APA
Matsuhashi, N., Takahashi, T., Tomita, H., Araki, H., Ibuka, T., Tanaka, K. ... Yoshida, K. (2017). Evaluation of treatment for rectal neuroendocrine tumors sized under 20 mm in comparison with the WHO 2010 guidelines. Molecular and Clinical Oncology, 7, 476-480. https://doi.org/10.3892/mco.2017.1326
MLA
Matsuhashi, N., Takahashi, T., Tomita, H., Araki, H., Ibuka, T., Tanaka, K., Tanahashi, T., Matsui, S., Sasaki, Y., Tanaka, Y., Okumura, N., Yamaguchi, K., Osada, S., Yoshida, K."Evaluation of treatment for rectal neuroendocrine tumors sized under 20 mm in comparison with the WHO 2010 guidelines". Molecular and Clinical Oncology 7.3 (2017): 476-480.
Chicago
Matsuhashi, N., Takahashi, T., Tomita, H., Araki, H., Ibuka, T., Tanaka, K., Tanahashi, T., Matsui, S., Sasaki, Y., Tanaka, Y., Okumura, N., Yamaguchi, K., Osada, S., Yoshida, K."Evaluation of treatment for rectal neuroendocrine tumors sized under 20 mm in comparison with the WHO 2010 guidelines". Molecular and Clinical Oncology 7, no. 3 (2017): 476-480. https://doi.org/10.3892/mco.2017.1326
Copy and paste a formatted citation
x
Spandidos Publications style
Matsuhashi N, Takahashi T, Tomita H, Araki H, Ibuka T, Tanaka K, Tanahashi T, Matsui S, Sasaki Y, Tanaka Y, Tanaka Y, et al: Evaluation of treatment for rectal neuroendocrine tumors sized under 20 mm in comparison with the WHO 2010 guidelines. Mol Clin Oncol 7: 476-480, 2017.
APA
Matsuhashi, N., Takahashi, T., Tomita, H., Araki, H., Ibuka, T., Tanaka, K. ... Yoshida, K. (2017). Evaluation of treatment for rectal neuroendocrine tumors sized under 20 mm in comparison with the WHO 2010 guidelines. Molecular and Clinical Oncology, 7, 476-480. https://doi.org/10.3892/mco.2017.1326
MLA
Matsuhashi, N., Takahashi, T., Tomita, H., Araki, H., Ibuka, T., Tanaka, K., Tanahashi, T., Matsui, S., Sasaki, Y., Tanaka, Y., Okumura, N., Yamaguchi, K., Osada, S., Yoshida, K."Evaluation of treatment for rectal neuroendocrine tumors sized under 20 mm in comparison with the WHO 2010 guidelines". Molecular and Clinical Oncology 7.3 (2017): 476-480.
Chicago
Matsuhashi, N., Takahashi, T., Tomita, H., Araki, H., Ibuka, T., Tanaka, K., Tanahashi, T., Matsui, S., Sasaki, Y., Tanaka, Y., Okumura, N., Yamaguchi, K., Osada, S., Yoshida, K."Evaluation of treatment for rectal neuroendocrine tumors sized under 20 mm in comparison with the WHO 2010 guidelines". Molecular and Clinical Oncology 7, no. 3 (2017): 476-480. https://doi.org/10.3892/mco.2017.1326
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