[Prognostic factor analysis of surgical treatment in patients with rectal neuroendocrine neoplasms].

OBJECTIVE

To analyze the prognostic factors and long-term surgical efficacies of rectal neuroendocrine neoplasm (NEN).

METHODS

The clinical and pathological data of 141 patients with rectal NENs treated between January 1999 and November 2012 were retrospectively analyzed. The Kaplan-Meier method was used to calculate survival time and Cox regression to analyze the clinicopathological factors correlating with patient prognosis.

RESULTS

The overall 1, 3 and 5-year survival rates were 95.4%, 87.0% and 82.8% respectively. According to the criteria of WHO classification (2010) and staging system about rectal NEN, there were grade 1 (G1) (n = 76, 79.2%), grade 2 (G2) (n = 12, 12.5%), neuroendocrine carcinoma (NEC) (n = 7, 7.3%) and mixed adenoneuroendocrine carcinoma (n = 1, 1.0%), the 1, 3 and 5-year survival rates were 98.6%, 43.7%,0% and 100.0% respectively. There were stage I (n = 71, 74.0%) , stage II (n = 5, 5.2%), stage III (n = 12, 12.5%) and stage IV (n = 8, 8.3%) . The 1, 3 and 5-year survival rates were 97.7%, 75.0%, 57.1% and 25.0% respectively.Univariate analysis showed that tumor diameter, histological grade, lymph node metastasis, distant metastasis, radical surgery and muscular layer invasion significantly affected the postoperative survival. And Cox multivariate analysis indicated that tumor diameter and histological grade were independent prognostic factors.

CONCLUSIONS

Rectal NENs vary significantly in their prognoses.However, radical surgery offers satisfactory long-term survival rates. An optimal surgical approach should be selected based on tumor size. And more radical surgery should be performed for neuroendocrine tumors >2 cm.