Endoscopic treatment of rectal neuroendocrine tumors: a consecutive analysis of multi-institutional data

Purpose The incidence of rectal neuroendocrine tumors (NETs) is increasing owing to a rise in colonoscopy screening. For the endoscopic removal of NETs, complete resection including the submucosal layer is essential. Therefore, appropriate endoscopic resection techniques are of critical importance....

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Main Authors: Jae Won Shin, Eun-Jung Lee, Sung Sil Park, Kyung Su Han, Chang Gyun Kim, Hee Chul Chang, Won Youn Kim, Eui Chul Jeong, Dong Hyun Choi
Format: Article
Language:English
Published: Korean Society of Coloproctology 2025-06-01
Series:Annals of Coloproctology
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Online Access:http://coloproctol.org/upload/pdf/ac-2024-00927-0132.pdf
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author Jae Won Shin
Eun-Jung Lee
Sung Sil Park
Kyung Su Han
Chang Gyun Kim
Hee Chul Chang
Won Youn Kim
Eui Chul Jeong
Dong Hyun Choi
author_facet Jae Won Shin
Eun-Jung Lee
Sung Sil Park
Kyung Su Han
Chang Gyun Kim
Hee Chul Chang
Won Youn Kim
Eui Chul Jeong
Dong Hyun Choi
author_sort Jae Won Shin
collection DOAJ
description Purpose The incidence of rectal neuroendocrine tumors (NETs) is increasing owing to a rise in colonoscopy screening. For the endoscopic removal of NETs, complete resection including the submucosal layer is essential. Therefore, appropriate endoscopic resection techniques are of critical importance. This study aimed to analyze data on rectal NETs and help provide guidance for their endoscopic treatment. Methods A retrospective analysis was conducted on data from patients who underwent resection for rectal NETs at 6 institutions between 2010 and 2021. Results A total of 1,406 tumors were resected from 1,401 patients. During a mean follow-up period of 55.4 months, there were 8 cases (0.5%) of recurrence. Overall, a complete resection was achieved in 77.6% of the patients, with modified endoscopic mucosal resection (mEMR) and endoscopic submucosal dissection (ESD) showing the highest rate at 86.0% and 84.9%, respectively, followed by conventional EMR (cEMR; 68.7%) and snare polypectomy (59.0%). In the subgroup analysis, statistically significant differences were observed in complete resection rates based on tumor size. ESD and mEMR demonstrated significantly higher complete resection rates compared with cEMR. Univariate and multivariate analyses showed that tumor location of the lower rectum and advanced techniques (mEMR and ESD) were significant prognostic factors for complete resection rates. Conclusion When encountering rectal subepithelial lesions on endoscopic examination, endoscopists should consider the possibility of NETs and carefully decide on the endoscopic treatment method. Therefore, it is advisable to perform mEMR or ESD to achieve complete resection, especially for rectal NETs measuring ≤10 mm.
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spelling doaj-art-02604b00e40a45da901b2601cf8ae13d2025-07-02T07:39:41ZengKorean Society of ColoproctologyAnnals of Coloproctology2287-97142287-97222025-06-0141322123110.3393/ac.2024.00927.01322089Endoscopic treatment of rectal neuroendocrine tumors: a consecutive analysis of multi-institutional dataJae Won Shin0Eun-Jung Lee1Sung Sil Park2Kyung Su Han3Chang Gyun Kim4Hee Chul Chang5Won Youn Kim6Eui Chul Jeong7Dong Hyun Choi8 Colonoscopy Study Group, The Korean Society of Coloproctology, Seoul, Korea Colonoscopy Study Group, The Korean Society of Coloproctology, Seoul, Korea Colonoscopy Study Group, The Korean Society of Coloproctology, Seoul, Korea Colonoscopy Study Group, The Korean Society of Coloproctology, Seoul, Korea Colonoscopy Study Group, The Korean Society of Coloproctology, Seoul, Korea Colonoscopy Study Group, The Korean Society of Coloproctology, Seoul, Korea Colonoscopy Study Group, The Korean Society of Coloproctology, Seoul, Korea Colonoscopy Study Group, The Korean Society of Coloproctology, Seoul, Korea Colonoscopy Study Group, The Korean Society of Coloproctology, Seoul, KoreaPurpose The incidence of rectal neuroendocrine tumors (NETs) is increasing owing to a rise in colonoscopy screening. For the endoscopic removal of NETs, complete resection including the submucosal layer is essential. Therefore, appropriate endoscopic resection techniques are of critical importance. This study aimed to analyze data on rectal NETs and help provide guidance for their endoscopic treatment. Methods A retrospective analysis was conducted on data from patients who underwent resection for rectal NETs at 6 institutions between 2010 and 2021. Results A total of 1,406 tumors were resected from 1,401 patients. During a mean follow-up period of 55.4 months, there were 8 cases (0.5%) of recurrence. Overall, a complete resection was achieved in 77.6% of the patients, with modified endoscopic mucosal resection (mEMR) and endoscopic submucosal dissection (ESD) showing the highest rate at 86.0% and 84.9%, respectively, followed by conventional EMR (cEMR; 68.7%) and snare polypectomy (59.0%). In the subgroup analysis, statistically significant differences were observed in complete resection rates based on tumor size. ESD and mEMR demonstrated significantly higher complete resection rates compared with cEMR. Univariate and multivariate analyses showed that tumor location of the lower rectum and advanced techniques (mEMR and ESD) were significant prognostic factors for complete resection rates. Conclusion When encountering rectal subepithelial lesions on endoscopic examination, endoscopists should consider the possibility of NETs and carefully decide on the endoscopic treatment method. Therefore, it is advisable to perform mEMR or ESD to achieve complete resection, especially for rectal NETs measuring ≤10 mm.http://coloproctol.org/upload/pdf/ac-2024-00927-0132.pdfcolonoscopyneuroendocrine tumorendoscopic mucosal resectionendoscopic submucosal dissection
spellingShingle Jae Won Shin
Eun-Jung Lee
Sung Sil Park
Kyung Su Han
Chang Gyun Kim
Hee Chul Chang
Won Youn Kim
Eui Chul Jeong
Dong Hyun Choi
Endoscopic treatment of rectal neuroendocrine tumors: a consecutive analysis of multi-institutional data
Annals of Coloproctology
colonoscopy
neuroendocrine tumor
endoscopic mucosal resection
endoscopic submucosal dissection
title Endoscopic treatment of rectal neuroendocrine tumors: a consecutive analysis of multi-institutional data
title_full Endoscopic treatment of rectal neuroendocrine tumors: a consecutive analysis of multi-institutional data
title_fullStr Endoscopic treatment of rectal neuroendocrine tumors: a consecutive analysis of multi-institutional data
title_full_unstemmed Endoscopic treatment of rectal neuroendocrine tumors: a consecutive analysis of multi-institutional data
title_short Endoscopic treatment of rectal neuroendocrine tumors: a consecutive analysis of multi-institutional data
title_sort endoscopic treatment of rectal neuroendocrine tumors a consecutive analysis of multi institutional data
topic colonoscopy
neuroendocrine tumor
endoscopic mucosal resection
endoscopic submucosal dissection
url http://coloproctol.org/upload/pdf/ac-2024-00927-0132.pdf
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