20.11.2019 | ASO Author Reflections
ASO Author Reflections: Revisiting Risk of Dissemination from Small Rectal Neuroendocrine Tumors
verfasst von:
Ian W. Folkert, MD, Robert E. Roses, MD
Erschienen in:
Annals of Surgical Oncology
|
Ausgabe 3/2020
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Excerpt
Tumor size has long been regarded as the primary risk factor for metastasis in rectal neuroendocrine tumors (RNETs). Increasing primary tumor size has been shown to correlate with an increased risk of dissemination.
1 This is reflected in the current guidelines for the management of RNETs. National Comprehensive Cancer Network (NCCN) guidelines recommend that < 1.0 cm completely resected tumors require no further work-up or surveillance.
2 Both NCCN and North American Neuroendocrine Tumor Society (NANETS) guidelines also state that small (< 2 cm) and diminutive (< 1 cm) tumors may be treated with transanal or endoscopic excision alone.
2,
3 Despite the prevailing view that small and diminutive RNETs are indolent, these tumors do metastasize, with a large systematic review finding that nearly 10% of tumors up to 1.0 cm in size metastasized.
4 Other factors, including tumor grade, have also been implicated as risk factors for metastasis;
1 however, the relative importance of these risk factors in predicting metastasis, especially in small and diminutive RNETs, remains unclear. …