Endoscopic resection yields reliable outcomes for small rectal neuroendocrine tumors.
OBJECTIVE
We analyzed the characteristics of gastrointestinal neuroendocrine tumors and examined the outcomes and safety of modalities in rectal neuroendocrine tumors.


METHODS
Between 2007 and 2011, a total of 91 patients with gastrointestinal neuroendocrine tumors were retrospectively reviewed in terms of the characteristics of tumors.


RESULTS
Sixty-six patients had rectal neuroendocrine tumors and underwent endoscopic mucosal resection (EMR, n = 29), endoscopic submucosal dissection (ESD, n = 23), or transanal endoscopic microsurgery (TEM, n = 14). The complete resection rate was higher in the ESD group (82.7%) and in the TEM group (100%) compared to the EMR group (65.5%) (P < 0.046). The complication rate was higher in the ESD group (47.8%) than in the EMR group (18.5%) (P = 0.003). No local tumor recurrence was observed in all patients, regardless of the procedure, during the median follow-up period of 21.5 ± 13.5 months.


CONCLUSIONS
ESD achieved a higher complete resection rate than EMR and comparable to TEM. Tumor recurrence was not observed in the endoscopic resection and TEM groups, regardless of the completeness of resection. Small neuroendocrine tumors of the gastrointestinal tract can be managed reliably with both endoscopic resection and TEM.
Department of Internal Medicine, the Catholic University of Korea College of Medicine, Seoul, Korea.
Joon Han
JH
Jeon
Dae Young
DY
Cheung
Seong Jin
SJ
Lee
Hyun Jin
HJ
Kim
Hye Kang
HK
Kim
Hyung Jun
HJ
Cho
In Kyu
IK
Lee
Jin Il
JI
Kim
Soo-Heon
SH
Park
Jae Kwang
JK
Kim
D000368:Aged; D004210:Dissection / Q000379:methods; D016099:Endoscopy, Gastrointestinal / Q000379:methods*; D005260:Female; D006801:Humans; D007413:Intestinal Mucosa / Q000473:pathology / Q000601:surgery*; D008297:Male; D008866:Microsurgery; D008875:Middle Aged; D018358:Neuroendocrine Tumors / Q000473:pathology / Q000601:surgery*; D011183:Postoperative Complications / Q000453:epidemiology; D012004:Rectal Neoplasms / Q000473:pathology / Q000601:surgery*; D056910:Republic of Korea / Q000453:epidemiology; D016896:Treatment Outcome
endoscopic mucosal resection (EMR); endoscopic submucosal dissection (ESD); neuroendocrine tumor; transanal endoscopic microsurgery