Skip to main content
Erschienen in: Journal of Gastrointestinal Surgery 4/2014

01.04.2014 | Original Article

Long-Term Outcome of Patients with Locally Resected High- and Low-Risk Rectal Carcinoid Tumors

verfasst von: Kohei Shigeta, Koji Okabayashi, Hirotoshi Hasegawa, Yoshiyuki Ishii, Hiroki Ochiai, Masashi Tsuruta, Makio Mukai, Kaori Kameyama, Toshio Uraoka, Naohisa Yahagi, Yuko Kitagawa

Erschienen in: Journal of Gastrointestinal Surgery | Ausgabe 4/2014

Einloggen, um Zugang zu erhalten

Abstract

Background

Tumor size and lymphovascular invasion are known high-risk factors for lymph node and distant metastasis in patients with rectal carcinoid tumors. However, the optimal treatment for these tumors remains controversial.

Aim

The aim of this paper is to compare the outcome of local or radical resection between patients with high-risk (tumor size >10 mm or lymphovascular invasion) disease and those with low-risk (tumor size ≤10 mm, no lymphovascular invasion) disease.

Methods

Patients with rectal carcinoid tumors treated between January 1990 and March 2010 were identified retrospectively and classified into low- and high-risk groups.

Results

In total, 83 patients with rectal carcinoid tumors were included, 53 (64 %) of whom were identified as low-risk and 30 (36 %) as high-risk. Local resection was performed in 50 (60 %) low-risk and 24 (29 %) high-risk patients, and postoperative recurrence was observed in one (1 %) of the high-risk patients who underwent local resection and one (11 %) who underwent radical resection. No recurrence was observed in the low-risk group. Kaplan–Meier analysis of the patients who underwent local resection revealed that the 10-year disease-free survival rate was 100 % in the low-risk group and 83.3 % in the high-risk group.

Conclusions

There was no significant difference in outcome between local and radical resection.
Literatur
1.
Zurück zum Zitat Maggard MA, O’Connell JB, Ko CY. Updated population-based review of carcinoid tumors. 2004; 240: 117–122. Maggard MA, O’Connell JB, Ko CY. Updated population-based review of carcinoid tumors. 2004; 240: 117–122.
2.
Zurück zum Zitat Hwang R RE, Cusack J, Tyler D Small bowel malignancies and carcinoid tumors.: Lippincott Williams & Wilkins., 2002 Hwang R RE, Cusack J, Tyler D Small bowel malignancies and carcinoid tumors.: Lippincott Williams & Wilkins., 2002
3.
Zurück zum Zitat Solcia E. KG, SobinLH. Histological typing of endocrine tumours. WHO International Histological Classification of Tumours. 2000 Solcia E. KG, SobinLH. Histological typing of endocrine tumours. WHO International Histological Classification of Tumours. 2000
4.
Zurück zum Zitat Soga J. Early-stage carcinoids of the gastrointestinal tract: an analysis of 1914 reported cases. Cancer 2005; 103: 1587–1595.PubMedCrossRef Soga J. Early-stage carcinoids of the gastrointestinal tract: an analysis of 1914 reported cases. Cancer 2005; 103: 1587–1595.PubMedCrossRef
5.
Zurück zum Zitat Yao JC, Phan AT, Chang DZ, Wolff RA, Hess K, Gupta S, Jacobs C, Mares JE, Landgraf AN, Rashid A, Meric-Bernstam F. Efficacy of RAD001 (everolimus) and octreotide LAR in advanced low- to intermediate-grade neuroendocrine tumors: results of a phase II study. J Clin Oncol 2008; 26: 4311-4318.PubMedCentralPubMedCrossRef Yao JC, Phan AT, Chang DZ, Wolff RA, Hess K, Gupta S, Jacobs C, Mares JE, Landgraf AN, Rashid A, Meric-Bernstam F. Efficacy of RAD001 (everolimus) and octreotide LAR in advanced low- to intermediate-grade neuroendocrine tumors: results of a phase II study. J Clin Oncol 2008; 26: 4311-4318.PubMedCentralPubMedCrossRef
6.
Zurück zum Zitat Anthony LB, Strosberg JR, Klimstra DS, Maples WJ, O’Dorisio TM, Warner RR, Wiseman GA, Benson AB, 3rd, Pommier RF, North American Neuroendocrine Tumor S. The NANETS consensus guidelines for the diagnosis and management of gastrointestinal neuroendocrine tumors (nets): well-differentiated nets of the distal colon and rectum. Pancreas 2010; 39(6): 767–774.PubMedCrossRef Anthony LB, Strosberg JR, Klimstra DS, Maples WJ, O’Dorisio TM, Warner RR, Wiseman GA, Benson AB, 3rd, Pommier RF, North American Neuroendocrine Tumor S. The NANETS consensus guidelines for the diagnosis and management of gastrointestinal neuroendocrine tumors (nets): well-differentiated nets of the distal colon and rectum. Pancreas 2010; 39(6): 767–774.PubMedCrossRef
7.
Zurück zum Zitat Konishi T, Watanabe T, Kishimoto J, Kotake K, Muto T, Nagawa H, Japanese Society for Cancer of the C, Rectum. Prognosis and risk factors of metastasis in colorectal carcinoids: results of a nationwide registry over 15 years. Gut 2007; 56: 863–868.PubMedCentralPubMedCrossRef Konishi T, Watanabe T, Kishimoto J, Kotake K, Muto T, Nagawa H, Japanese Society for Cancer of the C, Rectum. Prognosis and risk factors of metastasis in colorectal carcinoids: results of a nationwide registry over 15 years. Gut 2007; 56: 863–868.PubMedCentralPubMedCrossRef
8.
Zurück zum Zitat Mani S, Modlin IM, Ballantyne G, Ahlman H, West B. Carcinoids of the rectum. 1994; 179: 231–248. Mani S, Modlin IM, Ballantyne G, Ahlman H, West B. Carcinoids of the rectum. 1994; 179: 231–248.
10.
Zurück zum Zitat Higaki S, Nishiaki M, Mitani N, Yanai H, Tada M, Okita K. Effectiveness of local endoscopic resection of rectal carcinoid tumors. 1997; 29: 171–175. Higaki S, Nishiaki M, Mitani N, Yanai H, Tada M, Okita K. Effectiveness of local endoscopic resection of rectal carcinoid tumors. 1997; 29: 171–175.
11.
Zurück zum Zitat Naunheim KS, Zeitels J, Kaplan EL, Sugimoto J, Shen KL, Lee CH, Straus FH, 2nd. Rectal carcinoid tumors—treatment and prognosis. Surgery 1983; 94: 670–676.PubMed Naunheim KS, Zeitels J, Kaplan EL, Sugimoto J, Shen KL, Lee CH, Straus FH, 2nd. Rectal carcinoid tumors—treatment and prognosis. Surgery 1983; 94: 670–676.PubMed
12.
Zurück zum Zitat Ramage JK, Goretzki PE, Manfredi R, Komminoth P, Ferone D, Hyrdel R, Kaltsas G, Kelestimur F, Kvols L, Scoazec JY, Garcia MI, Caplin ME, Frascati Consensus Conference p. Consensus guidelines for the management of patients with digestive neuroendocrine tumours: well-differentiated colon and rectum tumour/carcinoma. Neuroendocrinology 2008; 87: 31–39.PubMedCrossRef Ramage JK, Goretzki PE, Manfredi R, Komminoth P, Ferone D, Hyrdel R, Kaltsas G, Kelestimur F, Kvols L, Scoazec JY, Garcia MI, Caplin ME, Frascati Consensus Conference p. Consensus guidelines for the management of patients with digestive neuroendocrine tumours: well-differentiated colon and rectum tumour/carcinoma. Neuroendocrinology 2008; 87: 31–39.PubMedCrossRef
13.
Zurück zum Zitat Modlin IM, Lye KD, Kidd M. A 5-decade analysis of 13,715 carcinoid tumors. Cancer 2003; 97: 934–959.PubMedCrossRef Modlin IM, Lye KD, Kidd M. A 5-decade analysis of 13,715 carcinoid tumors. Cancer 2003; 97: 934–959.PubMedCrossRef
14.
Zurück zum Zitat Onozato Y, Kakizaki S, Iizuka H, Sohara N, Mori M, Itoh H. Endoscopic treatment of rectal carcinoid tumors. 2010; 53: 169–176. Onozato Y, Kakizaki S, Iizuka H, Sohara N, Mori M, Itoh H. Endoscopic treatment of rectal carcinoid tumors. 2010; 53: 169–176.
15.
Zurück zum Zitat Scherubl H, Jensen RT, Cadiot G, Stolzel U, Kloppel G. Management of early gastrointestinal neuroendocrine neoplasms. 2011; 3: 133–139. Scherubl H, Jensen RT, Cadiot G, Stolzel U, Kloppel G. Management of early gastrointestinal neuroendocrine neoplasms. 2011; 3: 133–139.
16.
Zurück zum Zitat Park CH, Cheon JH, Kim JO, Shin JE, Jang BI, Shin SJ, Jeen YT, Lee SH, Ji JS, Han DS, Jung SA, Park DI, Baek IH, Kim SH, Chang DK. Criteria for decision making after endoscopic resection of well-differentiated rectal carcinoids with regard to potential lymphatic spread. 2011; 43: 790–795. Park CH, Cheon JH, Kim JO, Shin JE, Jang BI, Shin SJ, Jeen YT, Lee SH, Ji JS, Han DS, Jung SA, Park DI, Baek IH, Kim SH, Chang DK. Criteria for decision making after endoscopic resection of well-differentiated rectal carcinoids with regard to potential lymphatic spread. 2011; 43: 790–795.
17.
Zurück zum Zitat Iwashita A HS, Tsuda S, Ueki T, Iwasaki H, Kushima R, Yao T, Oshiro Y, Kurihara K. Clinicopathological study on carcinoid tumor of the rectum: mainly on comparison of cases with metastasis and those without metastasis (in Japanese with English abstract). 2005; 40: 151–162. Iwashita A HS, Tsuda S, Ueki T, Iwasaki H, Kushima R, Yao T, Oshiro Y, Kurihara K. Clinicopathological study on carcinoid tumor of the rectum: mainly on comparison of cases with metastasis and those without metastasis (in Japanese with English abstract). 2005; 40: 151–162.
18.
Zurück zum Zitat Ono H, Kondo H, Gotoda T, Shirao K, Yamaguchi H, Saito D, Hosokawa K, Shimoda T, Yoshida S. Endoscopic mucosal resection for treatment of early gastric cancer. World J Gastroenterol 2001; 48: 225–229. Ono H, Kondo H, Gotoda T, Shirao K, Yamaguchi H, Saito D, Hosokawa K, Shimoda T, Yoshida S. Endoscopic mucosal resection for treatment of early gastric cancer. World J Gastroenterol 2001; 48: 225–229.
19.
Zurück zum Zitat Saito Y, Uraoka T, Matsuda T, Emura F, Ikehara H, Mashimo Y, Kikuchi T, Fu KI, Sano Y, Saito D. Endoscopic treatment of large superficial colorectal tumors: a case series of 200 endoscopic submucosal dissections (with video). Gastrointestinal Endoscopy 2007; 66: 966–973.PubMedCrossRef Saito Y, Uraoka T, Matsuda T, Emura F, Ikehara H, Mashimo Y, Kikuchi T, Fu KI, Sano Y, Saito D. Endoscopic treatment of large superficial colorectal tumors: a case series of 200 endoscopic submucosal dissections (with video). Gastrointestinal Endoscopy 2007; 66: 966–973.PubMedCrossRef
20.
Zurück zum Zitat Fujishiro M, Yahagi N, Kakushima N, Kodashima S, Muraki Y, Ono S, Yamamichi N, Tateishi A, Oka M, Ogura K, Kawabe T, Ichinose M, Omata M. Outcomes of endoscopic submucosal dissection for colorectal epithelial neoplasms in 200 consecutive cases. Clinical Gastroenterology and Hepatology. 2007; 5(6): 678–683; quiz 645.PubMedCrossRef Fujishiro M, Yahagi N, Kakushima N, Kodashima S, Muraki Y, Ono S, Yamamichi N, Tateishi A, Oka M, Ogura K, Kawabe T, Ichinose M, Omata M. Outcomes of endoscopic submucosal dissection for colorectal epithelial neoplasms in 200 consecutive cases. Clinical Gastroenterology and Hepatology. 2007; 5(6): 678–683; quiz 645.PubMedCrossRef
21.
Zurück zum Zitat Ishii N, Horiki N, Itoh T, Maruyama M, Matsuda M, Setoyama T, Suzuki S, Uchida S, Uemura M, Iizuka Y, Fukuda K, Suzuki K, Fujita Y. Endoscopic submucosal dissection and preoperative assessment with endoscopic ultrasonography for the treatment of rectal carcinoid tumors. Surgical Endoscopy 2010; 24(6): 1413–1419.PubMedCrossRef Ishii N, Horiki N, Itoh T, Maruyama M, Matsuda M, Setoyama T, Suzuki S, Uchida S, Uemura M, Iizuka Y, Fukuda K, Suzuki K, Fujita Y. Endoscopic submucosal dissection and preoperative assessment with endoscopic ultrasonography for the treatment of rectal carcinoid tumors. Surgical Endoscopy 2010; 24(6): 1413–1419.PubMedCrossRef
22.
Zurück zum Zitat Baek IH. Endoscopic submucosal dissection or conventional endoscopic mucosal resection is an effective and safe treatment for rectal carcinoid tumors: a retrospective study. 2010; 20: 329–331.PubMed Baek IH. Endoscopic submucosal dissection or conventional endoscopic mucosal resection is an effective and safe treatment for rectal carcinoid tumors: a retrospective study. 2010; 20: 329–331.PubMed
23.
Zurück zum Zitat Holinga J, Khalid A, Fasanella K, Sanders M, Davison J, McGrath K. Metastatic risk of diminutive rectal carcinoid tumors: a need for surveillance rectal ultrasound? Gastrointestinal Endoscopy 2012; 75: 913–916.PubMedCrossRef Holinga J, Khalid A, Fasanella K, Sanders M, Davison J, McGrath K. Metastatic risk of diminutive rectal carcinoid tumors: a need for surveillance rectal ultrasound? Gastrointestinal Endoscopy 2012; 75: 913–916.PubMedCrossRef
24.
Zurück zum Zitat Konishi T, Watanabe T, Nagawa H, Oya M, Ueno M, Kuroyanagi H, Fujimoto Y, Akiyoshi T, Yamaguchi T, Muto T. Treatment of colorectal carcinoids: a new paradigm. 2010; 2: 153–156. Konishi T, Watanabe T, Nagawa H, Oya M, Ueno M, Kuroyanagi H, Fujimoto Y, Akiyoshi T, Yamaguchi T, Muto T. Treatment of colorectal carcinoids: a new paradigm. 2010; 2: 153–156.
Metadaten
Titel
Long-Term Outcome of Patients with Locally Resected High- and Low-Risk Rectal Carcinoid Tumors
verfasst von
Kohei Shigeta
Koji Okabayashi
Hirotoshi Hasegawa
Yoshiyuki Ishii
Hiroki Ochiai
Masashi Tsuruta
Makio Mukai
Kaori Kameyama
Toshio Uraoka
Naohisa Yahagi
Yuko Kitagawa
Publikationsdatum
01.04.2014
Verlag
Springer US
Erschienen in
Journal of Gastrointestinal Surgery / Ausgabe 4/2014
Print ISSN: 1091-255X
Elektronische ISSN: 1873-4626
DOI
https://doi.org/10.1007/s11605-014-2468-6

Weitere Artikel der Ausgabe 4/2014

Journal of Gastrointestinal Surgery 4/2014 Zur Ausgabe

Update Chirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

S3-Leitlinie „Diagnostik und Therapie des Karpaltunnelsyndroms“

Karpaltunnelsyndrom BDC Leitlinien Webinare
CME: 2 Punkte

Das Karpaltunnelsyndrom ist die häufigste Kompressionsneuropathie peripherer Nerven. Obwohl die Anamnese mit dem nächtlichen Einschlafen der Hand (Brachialgia parästhetica nocturna) sehr typisch ist, ist eine klinisch-neurologische Untersuchung und Elektroneurografie in manchen Fällen auch eine Neurosonografie erforderlich. Im Anfangsstadium sind konservative Maßnahmen (Handgelenksschiene, Ergotherapie) empfehlenswert. Bei nicht Ansprechen der konservativen Therapie oder Auftreten von neurologischen Ausfällen ist eine Dekompression des N. medianus am Karpaltunnel indiziert.

Prof. Dr. med. Gregor Antoniadis
Berufsverband der Deutschen Chirurgie e.V.

S2e-Leitlinie „Distale Radiusfraktur“

Radiusfraktur BDC Leitlinien Webinare
CME: 2 Punkte

Das Webinar beschäftigt sich mit Fragen und Antworten zu Diagnostik und Klassifikation sowie Möglichkeiten des Ausschlusses von Zusatzverletzungen. Die Referenten erläutern, welche Frakturen konservativ behandelt werden können und wie. Das Webinar beantwortet die Frage nach aktuellen operativen Therapiekonzepten: Welcher Zugang, welches Osteosynthesematerial? Auf was muss bei der Nachbehandlung der distalen Radiusfraktur geachtet werden?

PD Dr. med. Oliver Pieske
Dr. med. Benjamin Meyknecht
Berufsverband der Deutschen Chirurgie e.V.

S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“

Appendizitis BDC Leitlinien Webinare
CME: 2 Punkte

Inhalte des Webinars zur S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“ sind die Darstellung des Projektes und des Erstellungswegs zur S1-Leitlinie, die Erläuterung der klinischen Relevanz der Klassifikation EAES 2015, die wissenschaftliche Begründung der wichtigsten Empfehlungen und die Darstellung stadiengerechter Therapieoptionen.

Dr. med. Mihailo Andric
Berufsverband der Deutschen Chirurgie e.V.