Criteria for decision making after endoscopic resection of well-differentiated rectal carcinoids with regard to potential lymphatic spread

被引：115

作者：

Park, C. H. ^{[2
]}

Cheon, J. H. ^{[3
]}

Kim, J. O. ^{[4
]}

Shin, J. E. ^{[5
]}

Jang, B. I. ^{[6
]}

Shin, S. J. ^{[7
]}

Jeen, Y. T. ^{[8
]}

Lee, S. H. ^{[9
]}

Ji, J. S. ^{[10
]}

Han, D. S. ^{[11
]}

Jung, S. A. ^{[12
]}

Park, D. I. ^{[13
]}

Baek, I. H. ^{[14
]}

Kim, S. H. ^{[15
]}

Chang, D. K. ^{[1
]}

机构：

[1] Sungkyunkwan Univ, Samsung Med Ctr, Dept Internal Med, Div Gastroenterol,Sch Med, Seoul 135710, South Korea

[2] Hallym Univ, Coll Med, Sacred Heart Hosp, Dept Internal Med, Anyang, South Korea

[3] Yonsei Univ, Coll Med, Dept Internal Med, Seoul, South Korea

[4] Soon Chun Hyang Univ Hosp, Ctr Digest Dis, Inst Digest Res, Dept Internal Med, Seoul, South Korea

[5] Dankook Univ, Coll Med, Dept Internal Med, Cheonan, South Korea

[6] Yeungnam Univ, Coll Med, Dept Internal Med, Taegu, South Korea

[7] Ajou Univ, Sch Med, Dept Internal Med, Suwon 441749, South Korea

[8] Korea Univ, Coll Med, Dept Internal Med, Inst Digest Dis & Nutr, Seoul 136705, South Korea

[9] Soon Chun Hyang Univ Hosp, Dept Internal Med, Cheonan, South Korea

[10] Catholic Univ Korea, Our Lady Mercy Hosp, Dept Internal Med, Inchon, South Korea

[11] Hanyang Univ Hosp, Dept Internal Med, Kuri, South Korea

[12] Ewha Womans Univ, Sch Med, Dept Internal Med, Seoul, South Korea

[13] Sungkyunkwan Univ, Sch Med, Kangbuk Samsung Hosp, Dept Internal Med, Seoul 135710, South Korea

[14] Hallym Univ, Coll Med, Kangnam Sacred Heart Hosp, Dept Internal Med, Seoul, South Korea

[15] Sungkyunkwan Univ, Samsung Med Ctr, Sch Med, Dept Pathol, Seoul 135710, South Korea

来源：

ENDOSCOPY | 2011年 / 43卷 / 09期

关键词：

GASTROINTESTINAL-TRACT; NEUROENDOCRINE TUMORS; SUBMUCOSAL RESECTION; PROGNOSIS; METASTASIS;

D O I：

10.1055/s-0030-1256414

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

摘要：

Background and study aim: Rectal carcinoids are low-grade malignancies that are usually treated by endoscopic resection. However, on pathologic examination, resection margins that are positive for carcinoid cells are frequently found. Patient outcomes were reviewed after endoscopic resection of rectal carcinoids and the clinical significance of possible residual disease, as defined by pathologic and endoscopic examination, was evaluated. Patients and methods: The medical records and endoscopic findings of 347 patients presenting with rectal carcinoids to 14 university hospitals in Korea between January 1999 and June 2007 were retrospectively analyzed. Results: A total of 304 patients were treated with endoscopic resection, and 43 patents were treated with surgery. In the endoscopic resection group, the complete resection rate was 88.2% based on endoscopic appearance (CR-E) and 60.2% based on pathologic evaluation (CR-P). The agreement between CR-E and CR-P was low (K = 0.192). No residual tumors were found in 77 of 85 patients (90.6%) who were CR-E but not CR-P and who had endoscopic biopsy taken at 24-month follow-up. The receiver-operating characteristic curve identified an optimal cut-off value of 10.5 mm, at which the sensitivity and the specificity for metastasis were 100% and 89%, respectively. The risk factors for metastasis by multivariate analysis were tumor size, increased mitotic rate, and lymphovascular invasion. Conclusions: Endoscopic resection is a safe and effective modality for treating well-differentiated rectal carcinoids smaller than 10mm in diameter. Discrepancies were observed between CR-E and CR-P. The risk factors for metastasis were tumor size, increased mitotic rate, and lymphovascular invasion.

引用

页码：790 / 795

页数：6

共 37 条

[21] Saline-assisted endoscopic resection of rectal carcinoids: Cap aspiration method versus simple snare resection [J].