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BMC Surgery
Published in: BMC Surgery 1/2022

Open Access 01-12-2022 | Neuroendocrine Tumor | Research

Comparison between endoscopic mucosal resection with a cap and endoscopic submucosal dissection for rectal neuroendocrine tumors

Authors: Xiuli Zheng, Mingli Wu, Huihui Shi, Limian Er, Kan Wang, Ying Cao, Shengmian Li

Published in: BMC Surgery | Issue 1/2022

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Abstract

Background

The aim of this study is to evaluate and compare the safety and efficacy of endoscopic mucosal resection with a cap (EMR-c) with those of endoscopic submucosal dissection (ESD) for rectal neuroendocrine tumors (R-NETs) ≤ 15 mm in diameter, and to analyze the risk factors of incomplete resection.

Methods

A total of 122 patients who underwent EMR-c or ESD for R-NETs at the Fourth Hospital of Hebei Medical University between February 2007 and December 2020 were invovled in this study. The clinical outcomes of two groups were compared and evaluated.

Results

A total of 122 patients with 128 R-NETs underwent endoscopic resection (EMR-c, 80; ESD, 48). In terms of duration of operation, EMR-c was significantly shorter than ESD (p < 0.001). Univariate analysis and multivariate analysis suggested that tumor diameter ≥ 8 mm was an independent risk factor for incomplete resection in patients with R-NETs in this study.

Conclusions

Both EMR-c and ESD were safe and effective treatments for R-NETs ≤ 15 mm in diameter. In addition, tumor diameter ≥ 8 mm was an independent risk factor for incomplete resection.
Literature
1.
Folkert IW, Sinnamon AJ, Concors SJ, Bennett BJ, Fraker DL, Mahmoud NN, Metz DC, Stashek KM, Roses RE. Grade is a dominant risk factor for metastasis in patients with rectal neuroendocrine tumors. Ann Surg Oncol. 2020;27(3):855–63.CrossRef
2.
Konishi T, Watanabe T, Muto T, Kotake K, Nagawa H, Japanese SFCO. Site distribution of gastrointestinal carcinoids differs between races. Gut. 2006;55(7):1051–2.CrossRef
3.
Konishi T, Watanabe T, Kishimoto J, Kotake K, Muto T, Nagawa H, On BOTJ, Japanese SFCO. Prognosis and risk factors of metastasis in colorectal carcinoids: results of a nationwide registry over 15 years. Gut. 2007;56(6):863–8.CrossRef
4.
Kang HS, Kwon MJ, Kim T, Han J, Ju Y. Lymphovascular invasion as a prognostic value in small rectal neuroendocrine tumor treated by local excision: a systematic review and meta-analysis. Pathol Res Pract. 2019;215(11): 152642.CrossRef
5.
Lee J. Comparison between cap-assisted and ligation-assisted endoscopic mucosal resection for rectal neuroendocrine tumors. Ann Gastroenterol. 2020;33(4):385–90.PubMedPubMedCentral
6.
Park SB, Kim HW, Kang DH, Choi CW, Kim SJ, Nam HS. Advantage of endoscopic mucosal resection with a cap for rectal neuroendocrine tumors. World J Gastroenterol. 2015;21(31):9387–93.CrossRef
7.
Ahmed Y, Othman M. EMR/ESD: techniques, complications, and evidence. Curr Gastroenterol Rep. 2020;22(8):1–12.CrossRef
8.
Wang X, Chai N, Linghu E, Li H, Zhai Y, Feng X, Zhang W, Zou J, Li L, Xiang J. Efficacy and safety of hybrid endoscopic submucosal dissection compared with endoscopic submucosal dissection for rectal neuroendocrine tumors and risk factors associated with incomplete endoscopic resection. Ann Transl Med. 2020;8(6):368.CrossRef
9.
Wang X, Xiang L, Li A, Han Z, Li Y, Wang Y, Guo Y, Zuang K, Yan Q, Zhong J, et al. Endoscopic submucosal dissection for the treatment of rectal carcinoid tumors 7–16 mm in diameter. Int J Colorectal Dis. 2015;30(3):375–80.CrossRef
10.
Sivandzadeh GR, Ejtehadi F, Shoaee S, Aminlari L, Niknam R, Taghavi AR, Geramizadeh B, Hormati A, Safarpour AR, Bagheri Lankarani K. Endoscopic mucosal resection: still a reliable therapeutic option for gastrointestinal neuroendocrine tumors. BMC Gastroenterol. 2021;21(1):1–6.CrossRef
11.
Gu Q, Lin Y, Cen L, Xu M, Li H, Lin X, Lu C. Endoscopic ultrasonography is useful in the diagnosis and treatment of rectal neuroendocrine neoplasms: a case series. J Zhejiang Univ Sci B. 2019;20(10):861–4.CrossRef
12.
Kobayashi K, Katsumata T, Yoshizawa S, Sada M, Igarashi M, Saigenji K, Otani Y. Indications of endoscopic polypectomy for rectal carcinoid tumors and clinical usefulness of endoscopic ultrasonography. Dis Colon Rectum. 2005;48(2):285–91.CrossRef
13.
Hamada Y, Tanaka K, Hattori A, Umeda Y, Yukimoto H, Yamada R, Nakamura M, Miura H, Tsuboi J, Katsurahara M, et al. Clinical utility of endoscopic submucosal dissection using the pocket-creation method with a HookKnife and preoperative evaluation by endoscopic ultrasonography for the treatment of rectal neuroendocrine tumors. Surg Endosc. 2021;36(1):375–84.CrossRef
14.
Jetmore AB, Ray JE, Gathright JJB, Mcmullen KM, Hicks TC, Timmcke AE. Rectal carcinoids: the most frequent carcinoid tumor. Dis Colon Rectum. 1992;35(8):717–25.CrossRef
15.
Modlin IM, Kidd M, Latich I, Zikusoka MN, Shapiro MD. Current status of gastrointestinal carcinoids. Gastroenterology. 2005;128(6):1717–51.CrossRef
16.
Park SJ. Tips and tricks for better endoscopic treatment of colorectal tumors: usefulness of cap and band in colorectal endoscopic mucosal resection. Clin Endosc. 2013;46(5):492–4.CrossRef
17.
Oshitani N, Hamasaki N, Sawa Y, Hara J, Nakamura S, Matsumoto T, Kitano A, Arakawa T. Endoscopic resection of small rectal carcinoid tumours using an aspiration method with a transparent overcap. J Int Med Res. 2000;28(5):241–6.CrossRef
18.
Nagai T, Torishima R, Nakashima H, Ookawara H, Uchida A, Kai S, Sato R, Murakami K, Fujioka T. Saline-assisted endoscopic resection of rectal carcinoids: cap aspiration method versus simple snare resection. Endoscopy. 2004;36(3):202.CrossRef
19.
Yang DMP, Park YMP, Park SHM, Kim KMP, Ye BDMP, Byeon JMP, Myung SMP, Yang SMP. Cap-assisted EMR for rectal neuroendocrine tumors: comparisons with conventional EMR and endoscopic submucosal dissection (with videos). Gastrointest Endosc. 2016;83(5):1015–22.CrossRef
20.
Son H, Son H, Sohn DK, Sohn DK, Hong CW, Hong CW, Han KS, Han KS, Kim BC, Kim BC, et al. Factors associated with complete local excision of small rectal carcinoid tumor. Int J Colorectal Dis. 2013;28(1):57–61.CrossRef
21.
Imada-Shirakata Y, Sakai M, Kajiyama T, Kin G, Inoue K, Torii A, Kishimoto H, Ueda S, Okuma M. Endoscopic resection of rectal carcinoid tumors using aspiration lumpectomy. Endoscopy. 1997;29(1):34.CrossRef
22.
Chen R, Liu X, Sun S, Wang S, Ge N, Wang G, Guo J. Comparison of endoscopic mucosal resection with circumferential incision and endoscopic submucosal dissection for rectal carcinoid tumor. Surg Laparosc Endosc Percutan Tech. 2016;26(3):e56–61.CrossRef
23.
Takita M, Sakai E, Nakao T, Kimoto Y, Ishii R, Konishi T, Ueno S, Kanda K, Negishi R, Muramoto T, et al. Clinical outcomes of patients with small rectal neuroendocrine tumors treated using endoscopic submucosal resection with a ligation device. Digestion. 2019;99(1):72–8.CrossRef
24.
Kim J, Kim JH, Lee JY, Chun J, Im JP, Kim JS. Clinical outcomes of endoscopic mucosal resection for rectal neuroendocrine tumor. BMC Gastroenterol. 2018;18(1):77.CrossRef
25.
Choi CW, Park SB, Kang DH, Kim HW, Kim SJ, Nam HS, Ryu DG. The clinical outcomes and risk factors associated with incomplete endoscopic resection of rectal carcinoid tumor. Surg Endosc. 2017;31(12):5006–11.CrossRef
26.
Wang X, Chai N, Linghu E, Qiu S, Li L, Zou J, Xiang J, Li X. The outcomes of modified endoscopic mucosal resection and endoscopic submucosal dissection for the treatment of rectal neuroendocrine tumors and the value of endoscopic morphology classification in endoscopic resection. BMC Gastroenterol. 2020;20(1):1–12.CrossRef
27.
Park SS, Han KS, Kim B, Chang Kim B, Hong CW, Sohn DK, Chang HJ. Comparison of underwater endoscopic mucosal resection and endoscopic submucosal dissection of rectal neuroendocrine tumors (with videos). Gastrointest Endosc. 2020;91(5):1164–71.CrossRef
28.
Coutinho LMA, Lenz L, Kawaguti FS, Martins BC, Baba E, Gusmon C, Andrade G, Simas M, Safatle-Ribeiro A, Maluf-Filho F, et al. Underwater endoscopic mucosal resection for small rectal neuroendocrine tumors. Arq Gastroenterol. 2021;58(2):210–3.CrossRef
29.
Zheng X, Wu M, Er L, Deng H, Wang G, Jin L, Li S. Risk factors for lymph node metastasis and prognosis in colorectal neuroendocrine tumours. Int J Colorectal Dis. 2022;37(2):421–8.CrossRef
30.
Ricci AD, Pusceddu S, Panzuto F, Gelsomino F, Massironi S, De Angelis CG, Modica R, Ricco G, Torchio M, Rinzivillo M, et al. Assessment of the risk of nodal involvement in rectal neuroendocrine neoplasms: the NOVARA score, a multicentre retrospective study. J Clin Med. 2022;11(3):713.CrossRef
Metadata
Title
Comparison between endoscopic mucosal resection with a cap and endoscopic submucosal dissection for rectal neuroendocrine tumors
Authors
Xiuli Zheng
Mingli Wu
Huihui Shi
Limian Er
Kan Wang
Ying Cao
Shengmian Li
Publication date
01-12-2022
Publisher
BioMed Central
Published in
BMC Surgery / Issue 1/2022
Electronic ISSN: 1471-2482
DOI
https://doi.org/10.1186/s12893-022-01693-x

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