Retrospective Study
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World J Gastroenterol. Nov 21, 2014; 20(43): 16252-16257
Published online Nov 21, 2014. doi: 10.3748/wjg.v20.i43.16252
Characteristics and long-term prognosis of patients with rectal neuroendocrine tumors
Yihebali Chi, Feng Du, Hong Zhao, Jin-Wan Wang, Jian-Qiang Cai
Yihebali Chi, Feng Du, Hong Zhao, Jin-Wan Wang, Jian-Qiang Cai, Cancer Institute and Hospital, Chinese Academy of Medical Sciences, Beijing 100021, China
Author contributions: Chi Y and Du F contributed to writing the manuscript; Chi Y was responsible for the study design and for collecting the primary data and its translation; Du F was involved in patient follow-up, interpretation and analysis of the data, and the initial work in preparing the manuscript; all authors contributed to critical review of the manuscript and all read and approved the final version.
Correspondence to: Jian-Qiang Cai, Professor, Cancer Institute and Hospital, Chinese Academy of Medical Sciences, No. 17 Panjiayuannanli, Chaoyang District, Beijing 100021, China. yihebalichi@hotmail.com
Telephone: +86-10-88859155 Fax: +86-10-88859155
Received: April 8, 2014
Revised: June 9, 2014
Accepted: July 16, 2014
Published online: November 21, 2014
Abstract

AIM: To analyze the clinicopathologic characteristics and prognostic factors of rectal neuroendocrine tumors.

METHODS: The records of 48 patients with rectal neuroendocrine tumors who were treated at the Cancer Institute and Hospital, Chinese Academy of Medical Sciences, Beijing, from March 2004 to September 2009 were retrospectively reviewed. The clinicopathological data were extracted and analyzed, and patients were followed-up by telephone or follow-up letter to determine their survival status. Follow-up data were available for all 48 patients. Uni- and multivariate Cox regression analyses were performed to determine the prognostic factors significantly associated with overall survival.

RESULTS: The tumors occurred mostly in the middle and lower rectum, and the most prominent symptoms experienced by patients were hematochezia and diarrhea. The median distance between the tumors and the anal edges was 5.0 ± 2.257 cm, and the median diameter of the tumors was 0.8 ± 1.413 cm. The major pathological type was a typical carcinoid tumor, which accounted for 93.8% (45/48) of patients. Tumor-node-metastasis (TNM) stages I, II, III and IV tumors accounted for 78.8%, 3.9%, 9.6% and 7.7% of patients, respectively. The main treatment method, in 72.9% (35/48) of patients, was transanal extended excision. The 1-, 3- and 5-year survival rates of the whole group of patients were 100%, 93.7%, and 91.3%, respectively. Univariate analysis showed that age (P = 0.032), tumor diameter (P < 0.001), histological type (P < 0.001), TNM stage (P < 0.001), and surgical approach (P = 0.002) were all prognostic factors. On multivariate analysis, only the pathological type was shown to be an independent prognostic factor (HR = 2.797, 95%CI: 1.676-4.668, P = 0.004).

CONCLUSION: In patients with rectal neuroendocrine tumors, TNM stage I is the most common stage found, and lymph node or distant metastases are rarely seen. The pathological type of the tumor is an independent prognostic factor.

Keywords: Rectal neuroendocrine tumors, Clinical characteristics, Prognostic factors

Core tip: An analysis of the clinicopathologic characteristics of a group of 57 patients with pathologically-confirmed diagnoses of rectal neuroendocrine tumors showed that these tumors mostly occur in the middle and lower rectum. The most common tumor-node-metastasis stage found was stage I, and lymph node or distant metastases were rarely seen. The major pathological type was a typical carcinoid tumor. Transanal extended excisions generally produced satisfactory curative effects, and the 5-year survival rate was as high as 88.6%. A multivariate analysis of the patient and tumor characteristics indicated that the pathological type is an independent prognostic factor.