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Erschienen in: Surgical Endoscopy 10/2016

30.12.2015

The Ki-67 labeling index and lymphatic/venous permeation predict the metastatic potential of rectal neuroendocrine tumors

verfasst von: Shinya Sugimoto, Kinichi Hotta, Tadakazu Shimoda, Kenichiro Imai, Yuichiro Yamaguchi, Takashi Nakajima, Takuma Oishi, Keita Mori, Kohei Takizawa, Naomi Kakushima, Masaki Tanaka, Noboru Kawata, Hiroyuki Matsubayashi, Hiroyuki Ono

Erschienen in: Surgical Endoscopy | Ausgabe 10/2016

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Abstract

Background

Endoscopic resection has been used to treat small rectal neuroendocrine tumors (NETs). However, the indication for additional surgery after endoscopic resection is unclear. The aim of this study was to identify risk factors for rectal NET metastasis and to determine the indication for additional surgery.

Methods

Fifty-five patients with a total of 57 rectal NETs, treated between October 2003 and January 2013, were retrospectively divided into metastatic (11 lesions) and non-metastatic (46 lesions) groups. Tumor size, central depression, invasion depth, lymphatic and venous permeation, mitotic activity, nuclear abnormality, Ki-67 labeling index, and World Health Organization grading classification (G1 or G2) were compared between the groups. Patients underwent endoscopic submucosal resection with a ligation device, transanal full-thickness surgical resection, or radical surgery.

Results

By univariate analysis, the odds ratios (OR) for a Ki-67 labeling index >3.0 %, positive lymphatic or venous permeation, World Health Organization grading classification G2, tumor size >10 mm, submucosal invasion >4000 μm, and central depression were 120 (P < 0.001), 67.6 (P < 0.001), 58.7 (P < 0.001), 9.8 (P = 0.0037), 6.8 (P = 0.012), and 5.7 (P = 0.018), respectively. Multivariate logistic regression analyses showed that vascular permeation (OR 111; P = 0.006) and a Ki-67 labeling index >3.0 % (OR 88; P = 0.012) were independent risk factors for metastasis.

Conclusions

The Ki-67 labeling index and lymphatic/venous permeation were reliable predictors of rectal NET metastases.
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Metadaten
Titel
The Ki-67 labeling index and lymphatic/venous permeation predict the metastatic potential of rectal neuroendocrine tumors
verfasst von
Shinya Sugimoto
Kinichi Hotta
Tadakazu Shimoda
Kenichiro Imai
Yuichiro Yamaguchi
Takashi Nakajima
Takuma Oishi
Keita Mori
Kohei Takizawa
Naomi Kakushima
Masaki Tanaka
Noboru Kawata
Hiroyuki Matsubayashi
Hiroyuki Ono
Publikationsdatum
30.12.2015
Verlag
Springer US
Erschienen in
Surgical Endoscopy / Ausgabe 10/2016
Print ISSN: 0930-2794
Elektronische ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-015-4735-3

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