Long-term outcomes of 1–2 cm rectal neuroendocrine tumors after local excision or radical resection: A population-based multicenter study
Chengguo Li,
Minhao Yu,
Weizhen Liu,
Wei Zhang,
Weizhong Jiang,
Peng Zhang,
Xinyu Zeng,
Maojun Di,
Xiaofeng Liao,
Yongbin Zheng,
Zhiguo Xiong,
Lijian Xia,
Yueming Sun,
Rui Zhang,
Ming Zhong,
Guole Lin,
Rong Lin,
Kaixiong Tao
Affiliations
Chengguo Li
Department of Gastrointestinal Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
Minhao Yu
Department of Gastrointestinal Surgery, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200127, China
Weizhen Liu
Department of Gastrointestinal Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
Wei Zhang
Department of Colorectal Surgery, Shanghai Changhai Hospital, Naval Medical University, Shanghai, 200082, China
Weizhong Jiang
Department of Colorectal Surgery, Fujian Medical University Union Hospital, Fuzhou, 350001, China
Peng Zhang
Department of Gastrointestinal Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
Xinyu Zeng
Department of Gastrointestinal Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
Maojun Di
Department of Gastrointestinal Surgery, Taihe Hospital, Hubei University of Medicine, Shiyan, 442000, China
Xiaofeng Liao
Department of General Surgery, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science. Institute of Oncology, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, 441021, China
Yongbin Zheng
Department of Gastrointestinal Surgery, Renmin Hospital of Wuhan University, Wuhan, 430060, China
Zhiguo Xiong
Department of Gastrointestinal Surgery, Hubei Cancer Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430079, China
Lijian Xia
Department of Colorectal and Anal Surgery, The First Affiliated Hospital of Shandong First Medical University, Jinan, 250014, China
Yueming Sun
Department of Colorectal Surgery, Jiangsu Province Hospital, Nanjing Medical University, Nanjing, 210029, China
Rui Zhang
Department of Colorectal Cancer, Liaoning Cancer Hospital & Institute, Shenyang, 110042, China
Ming Zhong
Department of Gastrointestinal Surgery, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200127, China
Guole Lin
Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, 100730, China; Corresponding author. Department of General Surgery, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, No. 1 Shuai Fu Yuan, Dong Cheng District, Beijing, 100730, China.
Rong Lin
Department of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China; Corresponding author. Department of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China.
Kaixiong Tao
Department of Gastrointestinal Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China; Corresponding author. Department of Gastrointestinal Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1277 Jiefang Avenue, Wuhan 430022, Hubei Province, China.
Objectives: Studies on rectal neuroendocrine tumors (R-NETs) that are 1–2 cm in size are limited, and the optimal treatment for these tumors is not well established. Methods: Data from patients with primary localized R-NETs 1–2 cm in size were retrospectively collected from 17 large-scale referral medical centers in China. Long-term prognosis, quality of life (QOL), and fecal incontinence were evaluated, and the effects of local excision (LE) or radical resection (RR) were elucidated using propensity score matching (PSM). Results: A total of 272 patients were included in this study; 233 underwent LE, and the remaining 39 underwent RR. Patients in the LE group showed lower tumor location, fewer postoperative Clavien–Dindo III–V complications, more G1 tumors, and lower tumor stage. There were no significant differences in the relapse-free survival or overall survival (OS) between the LE and RR groups after PSM. Patients in the LE group reported superior physical, role, emotional, social, and cognitive functions, global QOL, and Wexner fecal incontinence scores compared with those in the RR group (all P 1.80 (OR = 4.50, 1.46–15.89, P = 0.012), and T3–T4 (OR = 36.31, 95% CI 7.85–208.62, P 1.8 or T3/T4 tumors, RR should be considered.
