Management of rectal neuroendocrine tumours by transanal endoscopic microsurgery.
NET
TEM
neuroendocrine tumour
surgery
transanal
Journal
Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland
ISSN: 1463-1318
Titre abrégé: Colorectal Dis
Pays: England
ID NLM: 100883611
Informations de publication
Date de publication:
05 2023
05 2023
Historique:
revised:
16
12
2022
received:
30
09
2022
accepted:
27
12
2022
medline:
1
6
2023
pubmed:
8
2
2023
entrez:
7
2
2023
Statut:
ppublish
Résumé
The objective of this study was to evaluate the safety and effectiveness of transanal endoscopic microsurgery for rectal neuroendocrine tumours. A retrospective cohort study of all pathology-confirmed rectal neuroendocrine tumours treated by transanal endoscopic microsurgery from April 2007 to December 2020 at a tertiary care centre was performed. Demographic, clinical, radiographic and pathological data were collected. Characteristics of patients with recurrence were examined. Descriptive statistics were performed. There were 58 patients treated by transanal endoscopic microsurgery excision. Referrals were for primary excision (15, 25.9%), completion re-excision after incomplete endoscopic removal (38, 65.5%) or locally recurrent rectal neuroendocrine tumours (5, 8.6%). The mean age of patients was 56.4 ± 11.9 years and 26 patients were women (44.8%). Mean tumour size was 7.4 ± 3.8 mm (range 1.0-15.0 mm). Most (86.4%) were Grade 1 tumours. Mean operative time was 37.2 ± 17.2 min and 56 patients (96.6%) were discharged on the same day. All patients had negative margins on final pathology. Of the 38 patients who were referred for completion re-excision after incomplete endoscopic removal, eight (21.1%) had residual tumour on final pathology. Three recurrences were diagnosed at 2.1, 4.5 and 12.5 years after excision. All recurrences were from Grade 1 or 2 primary tumours, less than 2 cm, and diagnosed radiographically. To date, this is the largest North American study looking at transanal endoscopic microsurgery for rectal neuroendocrine tumours. This technique is effective in managing primary, incompletely excised and recurrent tumours with good clinical and oncological outcomes.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1026-1035Informations de copyright
© 2023 Association of Coloproctology of Great Britain and Ireland.
Références
Schimmack S, Svejda B, Lawrence B, Kidd M, Modlin IM. The diversity and commonalities of gastroenteropancreatic neuroendocrine tumors. Langenbecks Arch Surg. 2011;396(3):273-98. https://doi.org/10.1007/s00423-011-0739-1
Sugimoto S, Hotta K, Shimoda T, Imai K, Yamaguchi Y, Nakajima T, et al. The Ki-67 labeling index and lymphatic/venous permeation predict the metastatic potential of rectal neuroendocrine tumors. Surg Endosc. 2016;30(10):4239-48. https://doi.org/10.1007/s00464-015-4735-3
Scherübl H. Rectal carcinoids are on the rise: early detection by screening endoscopy. Endoscopy. 2009;41(2):162-5. https://doi.org/10.1055/s-0028-1119456
Modlin IM, Lye KD, Kidd M. A 5-decade analysis of 13,715 carcinoid tumors. Cancer. 2003;97(4):934-59. https://doi.org/10.1002/cncr.11105
Neuroendocrine and Adrenal Tumors. National Comprehensive Cancer Network (NCCN). Published December 4, 2021. Accessed October 8, 2021. https://www.nccn.org/guidelines/guidelines-detail
Gleeson FC, Levy MJ, Dozois EJ, Larson DW, Wong Kee Song LM, Boardman LA. Endoscopically identified well-differentiated rectal carcinoid tumors: impact of tumor size on the natural history and outcomes. Gastrointest Endosc. 2014;80(1):144-51. https://doi.org/10.1016/j.gie.2013.11.031
Ramage JK, De Herder WW, Delle Fave G, et al. ENETS consensus guidelines update for colorectal neuroendocrine neoplasms. Neuroendocrinology. 2016;103(2):139-43. https://doi.org/10.1159/000443166
Kwaan MR, Goldberg JE, Bleday R. Rectal carcinoid tumors: review of results after endoscopic and surgical therapy. Arch Surg. 2008;143(5):471-5. https://doi.org/10.1001/archsurg.143.5.471
Singh S, Asa SL, Dey C, Kennecke H, Laidley D, Law C, et al. Diagnosis and management of gastrointestinal neuroendocrine tumors: an evidence-based Canadian consensus. Cancer Treat Rev. 2016;47:32-45. https://doi.org/10.1016/j.ctrv.2016.05.003
Caplin M, Sundin A, Nillson O, Baum RP, Klose KJ, Kelestimur F, et al. ENETS consensus guidelines for the management of patients with digestive neuroendocrine neoplasms: colorectal neuroendocrine neoplasms. Neuroendocrinology. 2012;95(2):88-97. https://doi.org/10.1159/000335594
Bertani E, Ravizza D, Milione M, Massironi S, Grana CM, Zerini D, et al. Neuroendocrine neoplasms of rectum: a management update. Cancer Treat Rev. 2018;66:45-55. https://doi.org/10.1016/j.ctrv.2018.04.003
Li P, Wu F, Zhao H, Dou L, Wang Y, Guo C, et al. Analysis of the factors affecting lymph node metastasis and the prognosis of rectal neuroendocrine tumors. Int J Clin Exp Pathol. 2015;8(10):13331-8.
Sauven P, Ridge JA, Quan SH, Sigurdson ER. Anorectal carcinoid tumors. Is aggressive surgery warranted? Ann Surg. 1990;211(1):67-71. https://doi.org/10.1097/00000658-199001000-00012
Kobayashi K, Katsumata T, Yoshizawa S, Sada M, Igarashi M, Saigenji K, et al. Indications of endoscopic polypectomy for rectal carcinoid tumors and clinical usefulness of endoscopic ultrasonography. Dis Colon Rectum. 2005;48(2):285-91. https://doi.org/10.1007/s10350-004-0765-y
Matsui K, Iwase T, Kitagawa M. Small, polypoid-appearing carcinoid tumors of the rectum: clinicopathologic study of 16 cases and effectiveness of endoscopic treatment. Am J Gastroenterol. 1993;88(11):1949-53.
Onozato Y, Kakizaki S, Iizuka H, Sohara N, Mori M, Itoh H. Endoscopic treatment of rectal carcinoid tumors. Dis Colon Rectum. 2010;53(2):169-76. https://doi.org/10.1007/DCR.0b013e3181b9db7b
Soga J. Early-stage carcinoids of the gastrointestinal tract: an analysis of 1914 reported cases. Cancer. 2005;103(8):1587-95. https://doi.org/10.1002/cncr.20939
Buess G, Kipfmüller K, Ibald R, et al. Clinical results of transanal endoscopic microsurgery. Surg Endosc. 1988;2(4):245-50. https://doi.org/10.1007/BF00705331
Middleton PF, Sutherland LM, Maddern GJ. Transanal endoscopic microsurgery: a systematic review. Dis Colon Rectum. 2005;48(2):270-84. https://doi.org/10.1007/s10350-004-0804-8
Kumar AS, Sidani SM, Kolli K, Stahl TJ, Ayscue JM, Fitzgerald JF, et al. Transanal endoscopic microsurgery for rectal carcinoids: the largest reported United States experience. Colorectal Dis. 2012;14(5):562-6. https://doi.org/10.1111/j.1463-1318.2011.02726.x
Chen WJ, Wu N, Zhou JL, Lin GL, Qiu HZ. Full-thickness excision using transanal endoscopic microsurgery for treatment of rectal neuroendocrine tumors. World J Gastroenterol. 2015;21(30):9142-9. https://doi.org/10.3748/wjg.v21.i30.9142
Brand M, Reimer S, Reibetanz J, Flemming S, Kornmann M, Meining A. Endoscopic full thickness resection vs. transanal endoscopic microsurgery for local treatment of rectal neuroendocrine tumors-a retrospective analysis. Int J Colorectal Dis. 2021;36(5):971-6. https://doi.org/10.1007/s00384-020-03800-x
Heidary B, Phang TP, Raval MJ, Brown CJ. Transanal endoscopic microsurgery: a review. Can J Surg. 2014;57(2):127-38. https://doi.org/10.1503/cjs.022412
Kinoshita T, Kanehira E, Omura K, Tomori T, Yamada H. Transanal endoscopic microsurgery in the treatment of rectal carcinoid tumor. Surg Endosc. 2007;21(6):970-4. https://doi.org/10.1007/s00464-006-9155-y
Son HJ, Sohn DK, Hong CW, Han KS, Kim BC, Park JW, et al. Factors associated with complete local excision of small rectal carcinoid tumor. Int J Colorectal Dis. 2013;28(1):57-61. https://doi.org/10.1007/s00384-012-1538-z
Jeon SM, Cheon JH. Rectal carcinoid tumors: pitfalls of conventional polypectomy. Clin Endosc. 2012;45(1):2-3. https://doi.org/10.5946/ce.2012.45.1.2
Maeda K, Maruta M, Utsumi T, Sato H, Masumori K, Matsumoto M. Digestive organs Minimally invasive surgery for carcinoid tumors in the rectum. Biomed Pharmacother. 2002;6:5-36.
Shigeta K, Okabayashi K, Hasegawa H, Ishii Y, Ochiai H, Tsuruta M, et al. Long-term outcome of patients with locally resected high- and low-risk rectal carcinoid tumors. J Gastrointest Surg. 2014;18(4):768-73. https://doi.org/10.1007/s11605-014-2468-6
Yangong H, Shi C, Shahbaz M, Zhengchuan N, Wang J, Liang B, et al. Diagnosis and treatment experience of rectal carcinoid (a report of 312 cases). Int J Surg. 2014;12(5):408-11. https://doi.org/10.1016/j.ijsu.2014.03.002
Shields CJ, Tiret E, Winter DC. International rectal carcinoid study group. Carcinoid tumors of the rectum: a multi-institutional international collaboration. Ann Surg. 2010;252(5):750-5. https://doi.org/10.1097/SLA.0b013e3181fb8df6
You YN, Hardiman KM, Bafford A, Poylin V, Francone TD, Davis K, et al. The American Society of Colon and Rectal Surgeons clinical practice guidelines for the Management of Rectal Cancer. Dis Colon Rectum. 2020;63(9):1191-222. https://doi.org/10.1097/DCR.0000000000001762
Christoforidis D, Cho HM, Dixon MR, Mellgren AF, Madoff RD, Finne CO. Transanal endoscopic microsurgery versus conventional transanal excision for patients with early rectal cancer. Ann Surg. 2009;249(5):776-82. https://doi.org/10.1097/SLA.0b013e3181a3e54b
Clancy C, Burke JP, Albert MR, O'Connell PR, Winter DC. Transanal endoscopic microsurgery versus standard transanal excision for the removal of rectal neoplasms: a systematic review and meta-analysis. Dis Colon Rectum. 2015;58(2):254-61. https://doi.org/10.1097/DCR.0000000000000309
Lee L, Edwards K, Hunter IA, Hartley JE, Atallah SB, Albert MR, et al. Quality of local excision for rectal neoplasms using transanal endoscopic microsurgery versus transanal minimally invasive surgery: a multi-institutional matched analysis. Dis Colon Rectum. 2017;60(9):928-35. https://doi.org/10.1097/DCR.0000000000000884
Mege D, Bridoux V, Maggiori L, Tuech JJ, Panis Y. What is the best tool for transanal endoscopic microsurgery (TEM)? A case-matched study in 74 patients comparing a standard platform and a disposable material. Int J Colorectal Dis. 2017;32(7):1041-5. https://doi.org/10.1007/s00384-016-2733-0
Melin AA, Kalaskar S, Taylor L, Thompson JS, Ternent C, Langenfeld SJ. Transanal endoscopic microsurgery and transanal minimally invasive surgery: is one technique superior? Am J Surg. 2016;212(6):1063-7. https://doi.org/10.1016/j.amjsurg.2016.08.017