Recommendation of long-term and systemic management according to the risk factors in rectal NETs patients

Scientific Reports. 2019;9(1):1-10 DOI 10.1038/s41598-018-37707-z

 

Journal Homepage

Journal Title: Scientific Reports

ISSN: 2045-2322 (Online)

Publisher: Nature Publishing Group

LCC Subject Category: Medicine | Science

Country of publisher: United Kingdom

Language of fulltext: English

Full-text formats available: PDF, HTML

 

AUTHORS

Motohiro Kojima (Division of Pathology, Exploratory Oncology Research & Clinical Trial Center, National Cancer Center)
Yu Chen (Laboratory of Fundamental Oncology, National Cancer Center Research Institute)
Koji Ikeda (Division of Surgical Oncology, National Cancer Center Hospital East)
Yuichiro Tsukada (Division of Surgical Oncology, National Cancer Center Hospital East)
Daigoro Takahashi (Division of Surgical Oncology, National Cancer Center Hospital East)
Shingo Kawano (Advanced Clinical Research of Cancer, Juntendo University Graduate School of Medicine)
Kota Amemiya (Advanced Clinical Research of Cancer, Juntendo University Graduate School of Medicine)
Masaaki Ito (Division of Surgical Oncology, National Cancer Center Hospital East)
Rieko Ohki (Laboratory of Fundamental Oncology, National Cancer Center Research Institute)
Atsushi Ochiai (Division of Pathology, Exploratory Oncology Research & Clinical Trial Center, National Cancer Center)

EDITORIAL INFORMATION

Blind peer review

Editorial Board

Instructions for authors

Time From Submission to Publication: 20 weeks

 

Abstract | Full Text

Abstract Rectal neuroendocrine tumors (NETs) are often found as small lesions, which can be treated by endoscopic resection. However, high risk cases with lymph node (LN) metastasis are indication of radical surgery. Furthermore, rectal NETs are often associated with late recurrences and/or multiple cancer development. Therefore, proper surgical indication and patients’ management are required. We investigated the clinicopathological features of 79 rectal NET cases in order to elucidate risk factors for synchronous LN metastasis, recurrence, and multiple cancers. Recently, we reported that in pancreatic NET patients, a loss of heterozygosity (LOH) in PHLDA3 was associated with poorer prognosis, and that LOH of both PHLDA3 and MEN1 was frequently observed. Therefore, PHLDA3 and MEN1 LOH were also assessed in rectal NET patients for their association with clinicopathological features. Of the 79 patients, LN metastases were found in 12.7%, recurrences in 3.8%, and multiple cancers in 30.4% of the subjects. PHLDA3 and MEN1 LOH were found in 60.0% and 66.7% of the subjects, respectively. Lymphatic invasion and WHO classification 2010 were found to be independent risks for LN metastasis. There were three cases of recurrence, all of which occurred more than 3 years after resection and two of which exhibited LN metastasis. Older age and LOH in PHLDA3 were associated with the presence of multiple cancers. Long-term and systemic management of patients with rectal NETs is therefore recommended in accordance with these risk factors.