Top

International Journal of Colorectal Disease

Published in:

01-11-2008 | Original Article

Clinicopathological characteristics and prognosis of rectal well-differentiated neuroendocrine tumors

Authors: Shunsuke Tsukamoto, Shin Fujita, Tomohiro Yamaguchi, Seiichiro Yamamoto, Takayuki Akasu, Yoshihiro Moriya, Hirokazu Taniguchi, Tadakazu Shimoda

Published in: International Journal of Colorectal Disease | Issue 11/2008

Abstract

Background

To clarify the oncological outcome of rectal well-differentiated neuroendocrine tumors (W/D NETs), we examined the clinicopathological characteristics and prognosis of patients with this neoplasm.

Materials and methods

A total of 23 patients who underwent surgical treatment with lymph node dissection for rectal W/D NETs between 1973 and 2007 were reviewed.

Results

Median tumor size measured preoperatively was 13 mm (range, 4–25 mm), and the median number of dissected lymph nodes was 16 (range, 1–46). The incidence of lymph node metastasis was 61% (14 of 23 cases). The smallest W/D NETs with lymph node metastasis was 10 mm in diameter. All the patients without lymph node metastasis survived without recurrence. Among 11 patients who had only regional lymph node metastasis, only one developed liver metastasis and died 13 months after initial surgery. Among three patients with lateral pelvic lymph node metastasis, two survived more than 5 years, although two had liver metastasis.

Conclusions

Because the incidence of lymph node metastasis is very high in patients with rectal W/D NETs greater than 10 mm in diameter, radical surgery is required. In this series, the outcome of rectal W/D NETs patients with lateral pelvic lymph node metastasis was better than expected.

Solcia E, Kloppel G, Sobin LH, Capella C, DeLellis RA, Heitz PU, Horvath E, Kovacs K, Lack E, Lloyd RV, Rosai J, Scheithauer BW (2000) Histological typing of endocrine tumours. WHO International Histological Classification of Endocrine Tumours, 2nd edn. Springer, Berlin

Kloppel G, Perren A, Heitz Pu (2004) The gastroenteropancreatic neuroendocrine cell system and its tumors: the WHO classification. Ann N Y Acad Sci 1014:13–27PubMedCrossRef

Godwin JD (1975) Carcinoid tumors—an analysis of 2837 cases. Cancer 60:560–569CrossRef

Caplin ME, Buscombe JR, Hilson AJ, Jones AL, Watkinson AF, Burrouqhs AK (1998) Carcinoid tumour. Lancet 352:799–805PubMedCrossRef

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

Shebani KO, Souba WW, Finkelstein DM, Stark PC, Elqadi KM, Tanabe KK, Ott MJ (1999) Prognosis and survival in patients with gastrointestinal tract carcinoid tumors. Ann Surg 229:815–821PubMedCrossRef

Ramage JK, Davies AH, Ardill J, Bax N, Caplin M, Grossman A, Hawkins R, McNicol AM, Reed N, Sutton R, Thakker R, Aylwin S, Breen D, Britton K, Buchanan K, Corrie P, Gillams A, Lewington V, McCance D, Meeran K, Watkinson A, UKNETwork for Neuroendocrine Tumours (2005) Guidelines for the management of gastroenteropancreatic neuroendocrine (including carcinoid) tumours. Gut 54(Suppl 4):iv1–iv16PubMedCrossRef

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

Seow-Cheoen F, Ho J (1993) Tiny carcinoids may be malignant. Dis Colon Rectum 36:309–310PubMedCrossRef

10.

Konishi T, Watanabe T, Kishimoto J, Kotake K, Muto T, Nagawa H (2007) Prognosis and risk factors of metastasis in colorectal carcinoids: results of a nationwide registry over 15 years. Gut 56:863–868PubMedCrossRef

11.

Morikawa E, Yasutomi M, Shindou K, Matsuda T, Mori N, Hida J, Kubo R, Kitaoka M, Nakamura M, Fujimoto K (1994) Distribution of metastatic lymph nodes in colorectal cancer by modified clearing method. Dis Colon Rectum 37:219–223PubMedCrossRef

12.

Ueno H, Yamauchi C, Hase K, Ichikura T, Mochizuki H (1999) Clinicopathological study of intrapelvic cancer spread to the iliac area in lower rectal adenocarcinoma by serial sectioning. Br J Surg 86:1532–1537PubMedCrossRef

13.

Takahashi T, Ueno M, Azekura K, Ohta H (2000) Lateral node dissection and total mesorectal excision for rectal cancer. Dis Colon Rectum 43(Suppl):S59–S68PubMedCrossRef

14.

Fujita S, Yamamoto S, Akasu T, Moriya Y (2003) Lateral pelvic lymph nodedissection for advanced lower rectal cancer. Br J Surg 90:1580–1585PubMedCrossRef

15.

Rindi G, Kloppel G, Couverald A, Komminoth P, Korner M, Lopes J, McNicol A, Nilsson O, Perren A, Scarpa A, Scoazec J, Wiedenmann B (2007) TNM staging of midgut and hindgut (neuro) endocrine tumors: a consensus proposal including a grading system. Virchows Arch 451:757–762PubMedCrossRef

16.

Hemminki K, Li X (2001) Incidence trends and risk factors of carcinoid tumors: a nationwide epidemiologic study from Sweden. Cancer 92:2204–2210PubMedCrossRef

17.

Soga J (2005) Early-stage carcinoids of the gastrointestinal tract: an analysis of 1914 reported cases. Cancer 103:1587–1595PubMedCrossRef

18.

Ramage JK, Goretzki PE, Manfredi R, Komminoth P, Ferone D, Hyrdel R, Kaltsas G, Kelestimur F, Kvols L, Scoazec JY, Garcia MS, Caplin ME, All other Consensus Conference participants (2008) Consensus guidelines for the management of patients with digestive neuroendocrine tumours: well-differentiated colon and rectum tumor/carcinoma. Neuroendocrinology 87:31–39PubMedCrossRef

19.

Gerdes J, Lemke H, Baisch H, Wacker HH, Schwab U, Stein H (1984) Cell cycle analysis of a cell proliferation-associated human nuclear antigen defined by the monoclonal antibody KI-67. J Immunol 133:1710–1715PubMed

20.

Hotta K, Shimoda T, Nakanishi Y, Saito D (2006) Usefulness of Ki-67 for predicting the metastatic potential of rectal carcinoids. Pathol Int 56:591–596PubMedCrossRef

21.

Rindi G, Villanacci V, Ubiali A (2000) Biological and molecular aspects of gastroenteropancreatic neuroendocrine tumors. Digestion 45:19–26CrossRef

22.

Heald RJ, Husband EM, Ryall RD (1982) The mesorectum in rectal cancer surgery—the clue to pelvic recurrence? Br J Surg 69:613–616PubMedCrossRef

23.

Enker WE (1992) Potency, cure, and local control in the operative treatment of rectal cancer. Arch Surg 127:1396–1402PubMed

24.

Yano H, Saito Y, Takeshita E, Miyake O, Ishizuka N (2007) Prediction of lateral pelvic node involvement in low rectal cancer by conventional computed tomography. Br J Surg 94:1014–1019PubMedCrossRef

25.

Maggard MA, O’Connell JB, Ko CY (2004) Updated population-based review of carcinoid tumors. Ann Surg 240:117–122PubMedCrossRef

Title: Clinicopathological characteristics and prognosis of rectal well-differentiated neuroendocrine tumors
Authors: Shunsuke Tsukamoto
Shin Fujita
Tomohiro Yamaguchi
Seiichiro Yamamoto
Takayuki Akasu
Yoshihiro Moriya
Hirokazu Taniguchi
Tadakazu Shimoda
Publication date: 01-11-2008
Publisher: Springer-Verlag
Published in: International Journal of Colorectal Disease / Issue 11/2008
Print ISSN: 0179-1958
Electronic ISSN: 1432-1262
DOI: https://doi.org/10.1007/s00384-008-0505-1

At a glance: The STEP trials

Springer Medicine

Clinicopathological characteristics and prognosis of rectal well-differentiated neuroendocrine tumors

Abstract

Background

Materials and methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Materials and methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 11/2008

Overexpression of FMNL2 is closely related to metastasis of colorectal cancer

Local recurrence after curative resection in patients with colon and rectal cancers

Role of Hypoxia-inducible factor-1α and Survivin in colorectal carcinoma progression

Therapeutic hydrogen peroxide enema causing severe acute colitis

Outcome of patients with clinical stage II or III rectal cancer treated without adjuvant radiotherapy

Continence disorders after anal surgery—a relevant problem?