title: Clinicopathological characteristics of rectal carcinoids.
abstract: OBJECTIVE
  Carcinoids are heterogeneous neuroendocrine tumors with malignant potential. The rectum is the third most common location for gastrointestinal carcinoids. We assessed the clinicopathological characteristics of rectal carcinoids.
  
  
  METHODS
  A retrospective study of 203 patients treated for rectal carcinoids at the Asan Medical Center, Seoul, Republic of Korea from 1991 to 2007.
  
  
  RESULTS
  The patients were on average 51 (18-83) years old. The male-to-female ratio was 1.48:1. Over half (62.1%) of the patients were asymptomatic. The most frequent symptoms in the symptomatic patients were abdominal pain (11.1%) and hematochezia (10.7%). Local excision was applied to 92.1%, low anterior resection to 4.9%, and biopsy only to 3.0% of total patients. Initially, 4.4% presented with distant metastasis. Distant metastasis rates for tumors < or =1 cm, >1 to < or =2 cm, and >2 cm were 1.7% (3/177), 15.0% (3/20), and 50.0% (3/6), respectively. In the follow-up period, three patients showed recurrences. The size, lymphovascular invasion, perineural invasion, and T and N stages were associated with distant metastasis. The overall 5-year survival rate was 94.0%. The TNM stage and presence of lymphovascular invasion were associated with lower survival.
  
  
  CONCLUSIONS
  The chance that a rectal carcinoid will develop distant metastases increases as the tumor increases in size, lymphovascular invasion or perineural invasion is present, and T and N stages increase. The TNM stage and presence of lymphovascular invasion were associated with lower survival. Treatment plan should be chosen carefully considering above factors.
authors.affiliation: Department of Surgery, University of Ulsan College of Medicine and Asan Medical Center, 388-1 Poongnap-dong, Songpa-gu, Seoul 138-736, Republic of Korea.
authors.forename: Sang Nam
authors.initials: SN
authors.lastname: Yoon
authors.forename: Chang Sik
authors.initials: CS
authors.lastname: Yu
authors.forename: Ui Sup
authors.initials: US
authors.lastname: Shin
authors.forename: Chan Wook
authors.initials: CW
authors.lastname: Kim
authors.forename: Seok-Byung
authors.initials: SB
authors.lastname: Lim
authors.forename: Jin Cheon
authors.initials: JC
authors.lastname: Kim
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002276:Carcinoid Tumor / Q000401:mortality / Q000473:pathology* / Q000628:therapy; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D012004:Rectal Neoplasms / Q000401:mortality / Q000473:pathology* / Q000628:therapy; D015996:Survival Rate; D055815:Young Adult
references.citation: Surgery. 2008 Sep;144(3):460-6
references.pmid: 18707046
references.citation: Gut. 1996 Oct;39(4):562-8
references.pmid: 8944566
references.citation: Jpn J Surg. 1989 Sep;19(5):544-8
references.pmid: 2593390
references.citation: Cancer. 2003 Feb 15;97(4):934-59
references.pmid: 12569593
references.citation: J Nucl Med. 2002 Jul;43(7):889-95
references.pmid: 12097458
references.citation: Gastrointest Endosc. 2006 Feb;63(2):243-9
references.pmid: 16427929
references.citation: Cancer. 1997 Apr 1;79(7):1294-8
references.pmid: 9083149
references.citation: Best Pract Res Clin Gastroenterol. 2005 Aug;19(4):491-505
references.pmid: 16183523
references.citation: Cancer. 1997 Feb 15;79(4):813-29
references.pmid: 9024720
references.citation: Surg Endosc. 2005 Aug;19(8):1151-4
references.pmid: 16021383
references.citation: Oncology. 2000 Sep;59(3):229-37
references.pmid: 11053991
references.citation: Gastroenterology. 2005 May;128(6):1717-51
references.pmid: 15887161
references.citation: Cancer. 2005 Apr 15;103(8):1587-95
references.pmid: 15742328
references.citation: Surg Endosc. 2008 Sep;22(9):1992-6
references.pmid: 18568372
references.citation: Ann Surg. 2000 Oct;232(4):549-56
references.pmid: 10998653
references.citation: Ann Surg Oncol. 2007 May;14(5):1735-43
references.pmid: 17294074