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Clinical Outcomes of Patients with Small Rectal Neuroendocrine Tumors Treated Using Endoscopic Submucosal Resection

Maiko Takita1, Eiji Sakai1, Tomomi Nakao1

  • 1Department of Gastroenterology, NTT Medical Center Tokyo, Tokyo, Japan.

Digestion
|December 17, 2018
PubMed
Abstract

Insights

Endoscopic submucosal resection with a ligation device (ESMR-L) is a safe and effective treatment for small rectal neuroendocrine tumors (NETs). Long-term outcomes are favorable, even with a high rate of lymphovascular invasion.

Area of Science:

  • Gastroenterology
  • Surgical Oncology
  • Endoscopic Therapeutics

Background:

  • Therapeutic strategies for small rectal neuroendocrine tumors (NETs) are not standardized.
  • Endoscopic submucosal resection with a ligation device (ESMR-L) is an emerging treatment option.

Purpose of the Study:

  • To evaluate the efficacy and safety of ESMR-L for rectal NETs <10 mm.
  • To assess the long-term outcomes following endoscopic treatment.

Main Methods:

  • Retrospective analysis of 181 patients with rectal NETs <10 mm treated with ESMR-L.
  • Pathological examination to guide follow-up strategies.
  • Evaluation of outcomes after a median follow-up of 53 months.

Main Results:

  • R0 resection was achieved in 99.4% of cases.
  • Lymphovascular invasion was present in 37.0% of tumors; curative resection in 63.0%.
  • Tumor size >5 mm predicted lymphovascular invasion (OR 2.06).
  • Low rates of perforation (0.6%) and delayed bleeding (6.1%) were observed.
  • No local or distant metastases were detected during follow-up.

Conclusions:

  • ESMR-L is an easy, safe, and effective endoscopic treatment for rectal NETs <10 mm.
  • Patients demonstrate a good prognosis despite a notable rate of lymphovascular invasion.
  • ESMR-L offers a promising therapeutic option for selected rectal NETs.
Keywords:
Endoscopic submucosal resection with a ligation deviceEndoscopic treatmentPrognosisRectal neuroendocrine tumor

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