Optimization of endoscopic treatment strategies for R0 resection of rectal neuroendocrine tumors smaller than 10 mm.

IF 2.6 4区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Clinics and research in hepatology and gastroenterology Pub Date : 2024-09-26 DOI:10.1016/j.clinre.2024.102469

Jieti Wang, Xiaolan Zhang, Ke Chen, Yun Liang, Yuan Liu, Ziting Jiang, Yiping He, Jie Chen, Jianqiang Liu

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引用次数: 0

Abstract

Background: The optimal histologically complete (R0) resection methods of endoscopy for rectal neuroendocrine tumor (NET) ≤ 10 mm remains controversial. We aimed to assess the optimal endoscopic treatments for NETs.

Methods: The retrospective enrolled patients (n = 208) with rectal NETs were divided into 3 subsets according to pathological tumor size: 2 - 3 mm, 4 - 5 mm, and 6 - 10 mm NETs. Factors associated with R0 resection according to different endoscopic treatments (accidental diagnostic biopsy by cold forceps, endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD)) and tumor size were investigated. All patients underwent follow-up and no local recurrence or metastasis were identified.

Results: A total of 208 patients were enrolled. In patients with 2 - 3 mm NETs, the R0 resection rate was 100.0 % for biopsy, EMR, and ESD. The R0 resection rate for biopsy of 4 - 5 mm and 6 - 10 mm NETs was 34.3 % and 0.0 % respectively, which was inferior to the EMR/ESD rate (4 - 5mm: p < 0.001; 6 - 10 mm: p < 0.001: respectively). For patients with ≤ 10 mm NETs, EMR and ESD had a comparable en bloc (p = 0.082) and R0 resection rates (p = 0.651).

Conclusion: Accidental diagnostic biopsy by cold forceps could be considered as the possible treatment for 2 - 3 mm rectal NETs. And for patients with ≤ 10 mm rectal NETs, both EMR and ESD might be sufficient.

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小于 10 毫米的直肠神经内分泌肿瘤 R0 切除术的内窥镜治疗策略优化。

背景：对于直肠神经内分泌肿瘤（NET）≤10 mm的最佳组织学完全（R0）切除方法仍存在争议。我们旨在评估NET的最佳内镜治疗方法：回顾性入组的直肠NET患者（n = 208）根据病理肿瘤大小分为3个亚组：2 - 3 mm、4 - 5 mm和6 - 10 mm的NET。研究人员根据不同的内镜治疗方法（冷钳意外诊断性活检、内镜下粘膜切除术（EMR）和内镜下粘膜下剥离术（ESD））和肿瘤大小调查了R0切除率的相关因素。所有患者均接受了随访，未发现局部复发或转移：结果：共有 208 名患者入选。在2-3毫米的NET患者中，活检、EMR和ESD的R0切除率均为100.0%。4-5毫米和6-10毫米NET活检的R0切除率分别为34.3%和0.0%，低于EMR/ESD的R0切除率（4-5毫米：P＜0.001；6-10毫米：P＜0.001）。对于≤10毫米的NET患者，EMR和ESD的全切率（p = 0.082）和R0切除率（p = 0.651）相当：结论：对于2-3毫米的直肠NET，可以考虑使用冷钳进行诊断性活检。对于≤10毫米的直肠NET患者，EMR和ESD可能都足够了。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinics and research in hepatology and gastroenterology GASTROENTEROLOGY & HEPATOLOGY-

CiteScore

4.30

自引率

3.70%

发文量

198

审稿时长

42 days

期刊介绍： Clinics and Research in Hepatology and Gastroenterology publishes high-quality original research papers in the field of hepatology and gastroenterology. The editors put the accent on rapid communication of new research and clinical developments and so called "hot topic" issues. Following a clear Editorial line, besides original articles and case reports, each issue features editorials, commentaries and reviews. The journal encourages research and discussion between all those involved in the specialty on an international level. All articles are peer reviewed by international experts, the articles in press are online and indexed in the international databases (Current Contents, Pubmed, Scopus, Science Direct). Clinics and Research in Hepatology and Gastroenterology is a subscription journal (with optional open access), which allows you to publish your research without any cost to you (unless you proactively chose the open access option). Your article will be available to all researchers around the globe whose institution has a subscription to the journal.