McConnell Yarrow J
Department of Surgery, University of British Columbia, 5th Floor, 2775 Laurel St., Vancouver, British Columbia, V5Z 1M9, Canada.
Am J Surg. 2016 May;211(5):877-85. doi: 10.1016/j.amjsurg.2016.01.008. Epub 2016 Feb 23.
Local excision of small (<10 mm) rectal carcinoids is a standard treatment. Actual patterns of care and outcomes are understudied because of the rarity of this tumor.
Surveillance, Epidemiology, and End Results database (1988 to 2012) was interrogated for rectal carcinoid patients. Chi-square testing and Kaplan-Meier survival analysis were used to compare survival outcomes.
Of all, 11,329 patients were identified-9,605 with only localized disease. The majority (77%) underwent local excision only. Full rectal resection was performed more frequently for tumors greater than 10 mm (11.7% to 12.2%) than for tumors less than 10 mm (4.5% to 4.9%, P < .001), and for higher T stage (T1: 4.0%, T2: 11.4%, T3/4:30.4%, P < .001). Nonoperative management was more common after year 2000 (11.2% to 13.7%) than prior (7.4% to 8.5%, P < .001). Cancer-specific survival improved across time periods but did not differ between nonoperative, local excision, or surgical resection.
Nonexcisional management of small, localized rectal carcinoids is becoming more common and may offer equivalent survival to excision or resection.
小（<10毫米）直肠类癌的局部切除是一种标准治疗方法。由于这种肿瘤罕见，实际的治疗模式和结果尚未得到充分研究。
对监测、流行病学和最终结果数据库（1988年至2012年）中的直肠类癌患者进行查询。采用卡方检验和Kaplan-Meier生存分析来比较生存结果。
总共确定了11329例患者，其中9605例仅患有局限性疾病。大多数（77%）仅接受了局部切除。对于大于10毫米的肿瘤（11.7%至12.2%），全直肠切除术的实施频率高于小于10毫米的肿瘤（4.5%至4.9%，P<.001），并且对于更高的T分期（T1：4.0%，T2：11.4%，T3/4：30.4%，P<.001）也是如此。2000年后非手术治疗更为常见（11.2%至13.7%），而之前为（7.4%至8.5%，P<.001）。特定癌症生存率在不同时间段有所提高，但在非手术、局部切除或手术切除之间没有差异。
小的局限性直肠类癌的非切除治疗越来越普遍，并且可能提供与切除或手术切除相当的生存率。
