Top

Published in:

01-09-2008

Atypical endoscopic features can be associated with metastasis in rectal carcinoid tumors

Authors: Byung Nyun Kim, Dae Kyung Sohn, Chang Won Hong, Kyung Su Han, Hee Jin Chang, Kyung Hae Jung, Seok-Byung Lim, Hyo Seong Choi, Seung-Yong Jeong, Jae-Gahb Park

Published in: Surgical Endoscopy | Issue 9/2008

Abstract

Background

Endoscopically, rectal carcinoids have a variety of sizes and features which may assist in determining treatment plans. The present study was performed to assess the relationship between endoscopic features and metastasis in rectal carcinoids.

Methods

A total of 115 rectal carcinoids of 112 patients with rectal carcinoids were enrolled, and the medical records were retrospectively reviewed. All tumors were classified according to size (longest diameter), and then according to endoscopic features such as shape, color, and surface changes including depressions, erosion, and ulceration. The relationship between endoscopic features and metastasis was evaluated.

Results

11 cases (9.6%) of the 115 rectal carcinoids presented with metastatic disease. Tumor size was associated with metastasis (p < 0.001). Endoscopic features associated with metastasis were tumor shape, surface change, and color (p < 0.001). Atypical endoscopic features occurred more frequently as the size of the tumor increased (p < 0.001). For tumors 10–19 mm in diameter, atypical surface change was associated with metastasis (p = 0.007).

Conclusions

Endoscopic features were found to be associated with metastasis in rectal carcinoids. In particular, atypical surface change may be useful in determining treatment plans for tumors 10–19 mm in diameter.

Fahy BN, Tang LH, Klimstra D, Wong WD, Guillem JG, Paty PB, Temple LK, Shia J, Weiser MR (2007) Carcinoid of the rectum risk stratification (CaRRs): a strategy for preoperative outcome assessment. Ann Surg Oncol 14:1735–1743PubMedCrossRef

Kobayashi K, Katsumata T, Yoshizawa S, Sada M, Igarashi M, Saigenji K, Otani Y (2005) Indications of endoscopic polypectomy for rectal carcinoid tumors and clinical usefulness of endoscopic ultrasonography. Dis Colon Rectum 48:285–291PubMedCrossRef

Rorstad O (2005) Prognostic indicators for carcinoid neuroendocrine tumors of the gastrointestinal tract. J Surg Oncol 89:151–160PubMedCrossRef

Soga J (1997) Carcinoids of the rectum: an evaluation of 1271 reported cases. Surg Today 27:112–119PubMedCrossRef

Modlin IM, Kidd M, Latich I, Zikusoka MN, Shapiro MD (2005) Current status of gastrointestinal carcinoids. Gastroenterology 128:1717–1751PubMedCrossRef

Wang AY, Ahmad NA (2006) Rectal carcinoids. Curr Opin Gastroenterol 22:529–535PubMedCrossRef

Koura AN, Giacco GG, Curley SA, Skibber JM, Feig BW, Ellis LM (1997) Carcinoid tumors of the rectum: effect of size, histopathology, and surgical treatment on metastasis free survival. Cancer 79:1294–1298PubMedCrossRef

Heah SM, Eu KW, Ooi BS, Ho YH, Seow-Choen F (2001) Tumor size is irrelevant in predicting malignant potential of carcinoid tumors of the rectum. Tech Coloproctol 5:73–77PubMedCrossRef

Okumura Y, Maruta M, Maeda K, Utsumi T, Tohyama K, Sato H, Masumori K, Matsumoto M, Koide Y, Ishihara O, Matsuoka H, Nogaki M (1997) Minute carcinoid tumor in the rectum with liver metastasis. Gan To Kagaku Ryoho 24(Suppl 2):307–312PubMed

10.

Tsuboi K, Shimura T, Suzuki H, Mochiki E, Haga N, Masuda N, Soda M, Yamamoto H, Asao T, Kuwano H (2004) Liver metastases of a minute rectal carcinoid less than 5 mm in diameter: a case report. Hepatogastroenterology 51:1330–1332PubMed

11.

Shim KN, Yang SK, Myung SJ, Chang HS, Jung SA, Choe JW, Lee YJ, Byeon JS, Lee JH, Jung HY, Hong WS, Kim JH, Min YI, Kim JC, Kim JS (2004) Atypical endoscopic features of rectal carcinoids. Endoscopy 36:313–316PubMedCrossRef

12.

Jetmore AB, Ray JE, Gathright JB Jr, McMullen KM, Hicks TC, Timmcke AE (1992) Rectal carcinoids: the most frequent carcinoid tumor. Dis Colon Rectum 35:717–725PubMedCrossRef

13.

Matsui K, Iwase T, Kitagawa M (1993) Small, polypoid-appearing carcinoid tumors of the rectum: clinicopathologic study of 16 cases and effectiveness of endoscopic treatment. Am J Gastroenterol 88:1949–1953PubMed

14.

Saito Y, Kondo H, Yokota T, Fujii T, Ono H, Gotoda T, Takigawa T, Saito D, Ishikawa T, Akasu T, Shimoda T (2000) A rectal carcinoid macroscopically simulating early cancer. Endoscopy 32:S17–S18PubMed

15.

Okamoto Y, Fujii M, Tateiwa S, Sakai T, Ochi F, Sugano M, Oshiro K, Masai K, Okabayashi Y (2004) Treatment of multiple rectal carcinoids by endoscopic mucosal resection using a device for esophageal variceal ligation. Endoscopy 36:469–470PubMedCrossRef

16.

Hunerbein M (2003) Endorectal ultrasound in rectal cancer. Colorectal Dis 5:402–405PubMedCrossRef

17.

Higaki S, Nishiaki M, Mitani N, Yanai H, Tada M, Okita K (1997) Effectiveness of local endoscopic resection of rectal carcinoid tumors. Endoscopy 29:171–175PubMedCrossRef

Title: Atypical endoscopic features can be associated with metastasis in rectal carcinoid tumors
Authors: Byung Nyun Kim
Dae Kyung Sohn
Chang Won Hong
Kyung Su Han
Hee Jin Chang
Kyung Hae Jung
Seok-Byung Lim
Hyo Seong Choi
Seung-Yong Jeong
Jae-Gahb Park
Publication date: 01-09-2008
Publisher: Springer-Verlag
Published in: Surgical Endoscopy / Issue 9/2008
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI: https://doi.org/10.1007/s00464-008-0006-x

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Atypical endoscopic features can be associated with metastasis in rectal carcinoid tumors

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 9/2008

Low-dose heparin for the prevention of post-ERCP pancreatitis: a randomized placebo-controlled trial

The first series of completely robotic esophagectomies with three-field lymphadenectomy: initial experience

Laparoscopic splenectomy for splenic masses

Port-access atrium retractors for totally endoscopic mitral valve surgery: The Tornado Retractor, the Butterfly Retractor, and the Semiautomatic Butterfly Retractor

Do the laparoscopic skills of trainees deteriorate over time?

Re editorial “the controversy regarding hand-assisted colorectal resection”