title: Long term outcomes of neuroendocrine carcinomas (high-grade neuroendocrine tumors) of the colon, rectum, and anal canal.
abstract: OBJECTIVE
  Neuroendocrine carcinomas (NEC) of the large intestine are rare and aggressive neoplasms. This study was designed to review the experience at a single institution and analyze the outcomes to improve our understanding of these tumors.
  
  
  METHODS
  The patients with NEC (high-grade neuroendocrine tumor) of the colon, rectum, and anal canal were identified from June 1993 to April 2011. Clinical features studied were patient demographics, presenting symptoms, tumor location, tumor stage, treatment status and length of follow-up.
  
  
  RESULTS
  Twenty-five patients were identified. Stages of the diseases were I (n=5), II (n=1), III (n=10) and IV (n=9). Locations of the tumors were: colon (36%); rectum (28%) and anal canal (36%). Rectal bleeding (36%) and pain (32%) were the most common symptoms but 16% of patients were asymptomatic. Among the patients with local or locally advanced disease, only five patients had surgery alone. The remainder of the patients underwent chemotherapy with/without radiation. Mean follow-up was 33.7 ± 8.4 months after diagnosis. NEC of the large bowel and anal canal has very distinctive pathologic features and a very poor prognosis. More than one third of the patients with NEC had metastatic disease at the time of diagnosis. When these tumors are in an advanced stage none of the treatment modalities impact on survival.
  
  
  CONCLUSIONS
  The present study showed the poor prognosis of these rare tumors.
authors.affiliation: Department of Colorectal Surgery, Digestive Disease Institute, Cleveland Clinic, Cleveland, OH, United States.
authors.forename: E
authors.initials: E
authors.lastname: Aytac
authors.affiliation: Department of Colorectal Surgery, Digestive Disease Institute, Cleveland Clinic, Cleveland, OH, United States.
authors.forename: Y
authors.initials: Y
authors.lastname: Ozdemir
authors.affiliation: Department of Colorectal Surgery, Digestive Disease Institute, Cleveland Clinic, Cleveland, OH, United States. Electronic address: ozunerg@ccf.org.
authors.forename: G
authors.initials: G
authors.lastname: Ozuner
mesh_terms: D001003:Anal Canal / Q000601:surgery; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001005:Anus Neoplasms / Q000175:diagnosis / Q000401:mortality / Q000628:therapy; D018278:Carcinoma, Neuroendocrine / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D059186:Chemoradiotherapy, Adjuvant; D017024:Chemotherapy, Adjuvant; D003082:Colectomy; D003110:Colonic Neoplasms / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D012004:Rectal Neoplasms / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D012007:Rectum / Q000601:surgery; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome
keywords: Anal canal; Colon; High-grade neuroendocrine tumors; Neuroendocrine carcinomas; Rectum