Long-term outcomes of 1–2 cm rectal neuroendocrine tumors after local excision or radical resection: A population-based multicenter study

Abstract

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.

Keywords

• Rectal neuroendocrine tumors
• Local excision
• Radical resection
• Quality of life
• Lymph node metastasis