Top

Published in:

01-04-2014 | Original Article

Long-Term Outcome of Patients with Locally Resected High- and Low-Risk Rectal Carcinoid Tumors

Authors: Kohei Shigeta, Koji Okabayashi, Hirotoshi Hasegawa, Yoshiyuki Ishii, Hiroki Ochiai, Masashi Tsuruta, Makio Mukai, Kaori Kameyama, Toshio Uraoka, Naohisa Yahagi, Yuko Kitagawa

Published in: Journal of Gastrointestinal Surgery | Issue 4/2014

Abstract

Background

Tumor size and lymphovascular invasion are known high-risk factors for lymph node and distant metastasis in patients with rectal carcinoid tumors. However, the optimal treatment for these tumors remains controversial.

Aim

The aim of this paper is to compare the outcome of local or radical resection between patients with high-risk (tumor size >10 mm or lymphovascular invasion) disease and those with low-risk (tumor size ≤10 mm, no lymphovascular invasion) disease.

Methods

Patients with rectal carcinoid tumors treated between January 1990 and March 2010 were identified retrospectively and classified into low- and high-risk groups.

Results

In total, 83 patients with rectal carcinoid tumors were included, 53 (64 %) of whom were identified as low-risk and 30 (36 %) as high-risk. Local resection was performed in 50 (60 %) low-risk and 24 (29 %) high-risk patients, and postoperative recurrence was observed in one (1 %) of the high-risk patients who underwent local resection and one (11 %) who underwent radical resection. No recurrence was observed in the low-risk group. Kaplan–Meier analysis of the patients who underwent local resection revealed that the 10-year disease-free survival rate was 100 % in the low-risk group and 83.3 % in the high-risk group.

Conclusions

There was no significant difference in outcome between local and radical resection.

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

Hwang R RE, Cusack J, Tyler D Small bowel malignancies and carcinoid tumors.: Lippincott Williams & Wilkins., 2002

Solcia E. KG, SobinLH. Histological typing of endocrine tumours. WHO International Histological Classification of Tumours. 2000

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

Yao JC, Phan AT, Chang DZ, Wolff RA, Hess K, Gupta S, Jacobs C, Mares JE, Landgraf AN, Rashid A, Meric-Bernstam F. Efficacy of RAD001 (everolimus) and octreotide LAR in advanced low- to intermediate-grade neuroendocrine tumors: results of a phase II study. J Clin Oncol 2008; 26: 4311-4318.PubMedCentralPubMedCrossRef

Anthony LB, Strosberg JR, Klimstra DS, Maples WJ, O’Dorisio TM, Warner RR, Wiseman GA, Benson AB, 3rd, Pommier RF, North American Neuroendocrine Tumor S. The NANETS consensus guidelines for the diagnosis and management of gastrointestinal neuroendocrine tumors (nets): well-differentiated nets of the distal colon and rectum. Pancreas 2010; 39(6): 767–774.PubMedCrossRef

Konishi T, Watanabe T, Kishimoto J, Kotake K, Muto T, Nagawa H, Japanese Society for Cancer of the C, Rectum. Prognosis and risk factors of metastasis in colorectal carcinoids: results of a nationwide registry over 15 years. Gut 2007; 56: 863–868.PubMedCentralPubMedCrossRef

Mani S, Modlin IM, Ballantyne G, Ahlman H, West B. Carcinoids of the rectum. 1994; 179: 231–248.

Sauven P, Ridge JA, Quan SH, Sigurdson ER. Anorectal carcinoid tumors. Is aggressive surgery warranted? Ann Surg 1990; 211(1): 67–71.PubMedCentralPubMedCrossRef

10.

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

11.

Naunheim KS, Zeitels J, Kaplan EL, Sugimoto J, Shen KL, Lee CH, Straus FH, 2nd. Rectal carcinoid tumors—treatment and prognosis. Surgery 1983; 94: 670–676.PubMed

12.

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

13.

Modlin IM, Lye KD, Kidd M. A 5-decade analysis of 13,715 carcinoid tumors. Cancer 2003; 97: 934–959.PubMedCrossRef

14.

Onozato Y, Kakizaki S, Iizuka H, Sohara N, Mori M, Itoh H. Endoscopic treatment of rectal carcinoid tumors. 2010; 53: 169–176.

15.

Scherubl H, Jensen RT, Cadiot G, Stolzel U, Kloppel G. Management of early gastrointestinal neuroendocrine neoplasms. 2011; 3: 133–139.

16.

Park CH, Cheon JH, Kim JO, Shin JE, Jang BI, Shin SJ, Jeen YT, Lee SH, Ji JS, Han DS, Jung SA, Park DI, Baek IH, Kim SH, Chang DK. Criteria for decision making after endoscopic resection of well-differentiated rectal carcinoids with regard to potential lymphatic spread. 2011; 43: 790–795.

17.

Iwashita A HS, Tsuda S, Ueki T, Iwasaki H, Kushima R, Yao T, Oshiro Y, Kurihara K. Clinicopathological study on carcinoid tumor of the rectum: mainly on comparison of cases with metastasis and those without metastasis (in Japanese with English abstract). 2005; 40: 151–162.

18.

Ono H, Kondo H, Gotoda T, Shirao K, Yamaguchi H, Saito D, Hosokawa K, Shimoda T, Yoshida S. Endoscopic mucosal resection for treatment of early gastric cancer. World J Gastroenterol 2001; 48: 225–229.

19.

Saito Y, Uraoka T, Matsuda T, Emura F, Ikehara H, Mashimo Y, Kikuchi T, Fu KI, Sano Y, Saito D. Endoscopic treatment of large superficial colorectal tumors: a case series of 200 endoscopic submucosal dissections (with video). Gastrointestinal Endoscopy 2007; 66: 966–973.PubMedCrossRef

20.

Fujishiro M, Yahagi N, Kakushima N, Kodashima S, Muraki Y, Ono S, Yamamichi N, Tateishi A, Oka M, Ogura K, Kawabe T, Ichinose M, Omata M. Outcomes of endoscopic submucosal dissection for colorectal epithelial neoplasms in 200 consecutive cases. Clinical Gastroenterology and Hepatology. 2007; 5(6): 678–683; quiz 645.PubMedCrossRef

21.

Ishii N, Horiki N, Itoh T, Maruyama M, Matsuda M, Setoyama T, Suzuki S, Uchida S, Uemura M, Iizuka Y, Fukuda K, Suzuki K, Fujita Y. Endoscopic submucosal dissection and preoperative assessment with endoscopic ultrasonography for the treatment of rectal carcinoid tumors. Surgical Endoscopy 2010; 24(6): 1413–1419.PubMedCrossRef

22.

Baek IH. Endoscopic submucosal dissection or conventional endoscopic mucosal resection is an effective and safe treatment for rectal carcinoid tumors: a retrospective study. 2010; 20: 329–331.PubMed

23.

Holinga J, Khalid A, Fasanella K, Sanders M, Davison J, McGrath K. Metastatic risk of diminutive rectal carcinoid tumors: a need for surveillance rectal ultrasound? Gastrointestinal Endoscopy 2012; 75: 913–916.PubMedCrossRef

24.

Konishi T, Watanabe T, Nagawa H, Oya M, Ueno M, Kuroyanagi H, Fujimoto Y, Akiyoshi T, Yamaguchi T, Muto T. Treatment of colorectal carcinoids: a new paradigm. 2010; 2: 153–156.

Title: Long-Term Outcome of Patients with Locally Resected High- and Low-Risk Rectal Carcinoid Tumors
Authors: Kohei Shigeta
Koji Okabayashi
Hirotoshi Hasegawa
Yoshiyuki Ishii
Hiroki Ochiai
Masashi Tsuruta
Makio Mukai
Kaori Kameyama
Toshio Uraoka
Naohisa Yahagi
Yuko Kitagawa
Publication date: 01-04-2014
Publisher: Springer US
Published in: Journal of Gastrointestinal Surgery / Issue 4/2014
Print ISSN: 1091-255X
Electronic ISSN: 1873-4626
DOI: https://doi.org/10.1007/s11605-014-2468-6

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Long-Term Outcome of Patients with Locally Resected High- and Low-Risk Rectal Carcinoid Tumors

Abstract

Background

Aim

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Aim

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 4/2014

How to Treat an Appendiceal Inflammatory Mass: Operatively or Nonoperatively?

Prevention of Delayed Gastric Emptying After Pylorus-Preserving Pancreatoduodenectomy with Antecolic Reconstruction, a Long Jejunal Loop, and a Jejuno-Jejunostomy

Laparoscopic Division of a Portosystemic Shunt for Recurrent Life-Threatening Rectal Variceal Bleeding: Report of a Case

Colorectal Emergencies: Perforated Diverticulitis (Operative and Nonoperative Management)

What Is the Effect of Stoma Construction on Surgical Site Infection After Colorectal Surgery?

Erratum to: Defining Incidence and Risk Factors of Venous Thromboembolism after Hepatectomy