Safety and Efficacy of Endoscopic Submucosal Dissection for Rectal Neuroendocrine Tumor

Abstract

Objective To investigate the effects of endoscopic submucosal dissection (ESD) on rectal neuroendocrine tumor(RNET) and evaluate its safety. Methods We retrospectively analyzed the clinical data of 80 patients (91 lesions) diagnosed as RNET underwent rectal ESD from January 2011 to December 2017 in Jiangsu Provincial People's Hospital. All patients were followed up. Results All lesions were completely resected. Symptomatic patients had different degrees of relief from the 3rd days to 2 months after surgery. There was no serious postoperative complication. The positive rate of margin was 20.88% (19/91). The suspicious positive rate of margin was 35.16% (32/91). The maximum long diameter of specimen was 20 mm. Tumor size ≥10mm and Grade G2 were associated with suspicious positive and positive margin in univariate analysis(P < 0.05). Grade G2 was identified as independent risk factor in multivariate analysis (P < 0.05). Only one patient in this study was confirmed to be RNET preoperatively. Median follow-up was 34 months and the recurrence rate was 4.40% (4/91). Conclusion ESD is effective in the treatment of G1 and G2 grades RNET patients with tumor diameter < 20mm. For RNET patients with positive margin and suspicious positive margin after ESD, close follow-up without additional treatment seems to be a feasible option.

Keywords

• endoscopic submucosal dissection(esd)
• rectum
• neuroendocrine tumor(net)