title: Colon and rectum neuroendocrine tumors: experience of the National Cancer Institute in Brazil.
abstract: BACKGROUND
  Neuroendocrine tumors (NETs) are rare, comprising nearly 0.49% of all malignancies. The majority occurs in the gastrointestinal tract.
  
  
  OBJECTIVE
  To analyze the demographic factors, clinicopathologic features, treatment employed, prognostic factors and the oncologic results related to colorectal NETs.
  
  
  METHODS
  Between the period from 1996 to 2010 174 patients were treated. From these, 34 were localized in the colon and rectum. Demographic factors, stage, therapeutics and its results were analyzed. All patients were followed for more than three years with image exams, urinary 5-hydroxyindolacetic acid (5-HIIA), serum chromogranin A and prostatic acid phosphatase.
  
  
  RESULTS
  The median age was 54,4 years (22-76), the majority was female (64,7%). Out of the 12 patients with colon NETs, one (8.3%) patient was classified as Stage IA; one (8.3%) as Stage IB; three (25%) as Stage IIIB and seven (58.4%) as Stage IV. Out of the 22 patients with rectum NETs, six (27.3%) were classified as Stage IA; four (18.2%) as IB; three (13.6 %) as IIIA; one (4.5%) as IIIB and eight (36.4%) as IV. Of rectal NETs, nine (41%) were treated with endoscopic resection, six (27.2%) underwent conventional surgical treatment and six (27.2%) were treated with chemotherapy. Eleven patients with colon NETs (91.6%) were surgically treated, seven of them with palliative surgery, one (8.4%) was treated with endoscopic resection and no patient was submitted to chemotherapy. After an average follow-up of 55 months, 19 (55%) patients were alive. Analyzing the overall survival was obtained an average overall survival of 29 months in Stage IA, 62 months in IB, 12 months in IIIA, 31 months in IIIB and 39 months in IV.
  
  
  CONCLUSIONS
  The treatment of colon and rectal NETs is complex, because it depends of the individuality of each patient. With adequate management, the prognosis can be favorable with long survival, but it is related to the tumor differentiation degree, efficacy of the chosen treatment and to the patient adhesion to the follow-up after treatment.
authors.affiliation: Department of Abdominopelvic Surgery, Cancer National Institute - INCA, Rio de Janeiro, RJ, Brazil. danielcesar@live.com
authors.forename: Daniel
authors.initials: D
authors.lastname: Cesar
authors.forename: Renato Morato
authors.initials: RM
authors.lastname: Zanatto
authors.forename: Marcus Vinícius Motta Valadão
authors.initials: MV
authors.lastname: da Silva
authors.forename: Rinaldo
authors.initials: R
authors.lastname: Golçalves
authors.forename: Eduardo Linhares Riello
authors.initials: EL
authors.lastname: de Mello
authors.forename: José Paulo
authors.initials: JP
authors.lastname: de Jesus
mesh_terms: D000047:Academies and Institutes; D000328:Adult; D000368:Aged; D000465:Algorithms; D001938:Brazil; D003110:Colonic Neoplasms / Q000175:diagnosis / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018358:Neuroendocrine Tumors; D012004:Rectal Neoplasms / Q000175:diagnosis / Q000601:surgery; D055815:Young Adult