title: [Rectal neuroendocrine tumors: surgical therapy].
abstract: The incidence of rectal neuroendocrine tumors (NET) has increased in recent years. Most of these neoplasms are asymptomatic and are diagnosed by colonoscopy screening, which could be one of the reasons for the increasing occurrence. As less than 1 % of rectal NET produce serotonin they are practically never discovered due to a carcinoid syndrome. The current guidelines of the European (ENETS) and North American (NANETS) Neuroendocrine Tumor Societies support clinicians with useful diagnostic and treatment algorithms. The most important criteria for therapy are tumor size and histopathological risk factors for metastases. For well-differentiated rectal neuroendocrine neoplasms < 1 cm, local endoscopic or surgical excision is recommended. Due to the lack of evidence tumors sized 1-2 cm represent a grey area for prognosis and treatment. All NET > 1.5 cm must be excised by radical surgery as low anterior rectal resection or abdominoperineal extirpation with total mesorectal excision (TME). Resectable liver and lung metastases of well-differentiated NETs should be surgically treated with curative intent.
authors.affiliation: Klinik für Allgemein-, Viszeral- und Thoraxchirurgie, Städtisches Klinikum Dresden-Friedrichstadt, Friedrichstrasse 41, 01067, Dresden, Deutschland.
authors.forename: O
authors.initials: O
authors.lastname: Radulova-Mauersberger
authors.affiliation: Klinik für Allgemein-, Viszeral- und Thoraxchirurgie, Städtisches Klinikum Dresden-Friedrichstadt, Friedrichstrasse 41, 01067, Dresden, Deutschland.
authors.forename: S
authors.initials: S
authors.lastname: Stelzner
authors.affiliation: Klinik für Allgemein-, Viszeral- und Thoraxchirurgie, Städtisches Klinikum Dresden-Friedrichstadt, Friedrichstrasse 41, 01067, Dresden, Deutschland. helmut.witzigmann@khdf.de.
authors.forename: H
authors.initials: H
authors.lastname: Witzigmannn
mesh_terms: D000465:Algorithms; D003113:Colonoscopy; D055088:Early Detection of Cancer; D042241:Early Diagnosis; D019983:Guideline Adherence; D006801:Humans; D008113:Liver Neoplasms / Q000473:pathology / Q000556:secondary / Q000601:surgery; D008175:Lung Neoplasms / Q000473:pathology / Q000556:secondary / Q000601:surgery; D018358:Neuroendocrine Tumors / Q000473:pathology / Q000601:surgery*; D011379:Prognosis; D012004:Rectal Neoplasms / Q000473:pathology / Q000601:surgery*; D047368:Tumor Burden
keywords: Liver resection; Neuroendocrine tumors; Rectal resection; Surgical therapy; Total mesorectal excision