title: Surgical management of rectal carcinoids: trends and outcomes from the Surveillance, Epidemiology, and End Results database (1988 to 2012).
abstract: BACKGROUND
  Local excision of small (<10 mm) rectal carcinoids is a standard treatment. Actual patterns of care and outcomes are understudied because of the rarity of this tumor.
  
  
  METHODS
  Surveillance, Epidemiology, and End Results database (1988 to 2012) was interrogated for rectal carcinoid patients. Chi-square testing and Kaplan-Meier survival analysis were used to compare survival outcomes.
  
  
  RESULTS
  Of all, 11,329 patients were identified-9,605 with only localized disease. The majority (77%) underwent local excision only. Full rectal resection was performed more frequently for tumors greater than 10 mm (11.7% to 12.2%) than for tumors less than 10 mm (4.5% to 4.9%, P < .001), and for higher T stage (T1: 4.0%, T2: 11.4%, T3/4:30.4%, P < .001). Nonoperative management was more common after year 2000 (11.2% to 13.7%) than prior (7.4% to 8.5%, P < .001). Cancer-specific survival improved across time periods but did not differ between nonoperative, local excision, or surgical resection.
  
  
  CONCLUSIONS
  Nonexcisional management of small, localized rectal carcinoids is becoming more common and may offer equivalent survival to excision or resection.
authors.affiliation: Department of Surgery, University of British Columbia, 5th Floor, 2775 Laurel St., Vancouver, British Columbia, V5Z 1M9, Canada. Electronic address: yarrow.mcconnell@vch.com.
authors.forename: Yarrow J
authors.initials: YJ
authors.lastname: McConnell
mesh_terms: D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D001955:British Columbia; D002276:Carcinoid Tumor / Q000401:mortality* / Q000473:pathology / Q000601:surgery*; D016009:Chi-Square Distribution; D003082:Colectomy / Q000009:adverse effects / Q000379:methods; D016208:Databases, Factual; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007414:Intestinal Neoplasms / Q000401:mortality* / Q000473:pathology / Q000601:surgery*; D053208:Kaplan-Meier Estimate; D008198:Lymph Nodes / Q000473:pathology* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009361:Neoplasm Invasiveness / Q000473:pathology; D009367:Neoplasm Staging; D011379:Prognosis; D012004:Rectal Neoplasms / Q000401:mortality* / Q000473:pathology / Q000601:surgery*; D012189:Retrospective Studies; D018426:SEER Program; D016019:Survival Analysis; D016896:Treatment Outcome
keywords: Carcinoid; Epidemiology; Neuroendocrine tumor; Outcomes; Rectum; Transanal excision