Ricci Angela Dalia, Pusceddu Sara, Panzuto Francesco, Gelsomino Fabio, Massironi Sara, De Angelis Claudio Giovanni, Modica Roberta, Ricco Gianluca, Torchio Martina, Rinzivillo Maria, Prinzi Natalie, Rizzi Felice, Lamberti Giuseppe, Campana Davide
Department of Experimental, Diagnostic and Specialty Medicine, Sant'Orsola-Malpighi University Hospital, ENETS Center of Excellence, 40138 Bologna, Italy.
Division of Medical Oncology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via P. Albertoni 15, 40138 Bologna, Italy.
J Clin Med. 2022 Jan 28;11(3):713. doi: 10.3390/jcm11030713.
Rectal neuroendocrine tumors (r-NETs) are rare tumors with overall good prognosis after complete resection. However, there is no consensus on the extension of lymphadenectomy or regarding contraindications to extensive resection. In this study, we aim to identify predictive factors that correlate with nodal metastasis in patients affected by G1-G2 r-NETs. A retrospective analysis of G1-G2 r-NETs patients from eight tertiary Italian centers was performed. From January 1990 to January 2020, 210 patients were considered and 199 were included in the analysis. The data for nodal status were available for 159 cases. The nodal involvement rate was 9%. A receiver operating characteristic (ROC) curve analysis was performed to identify the diameter (>11.5 mm) and Ki-67 (3.5%), respectively, as cutoff values to predict nodal involvement. In a multivariate analysis, diameter > 11.5 mm and vascular infiltration were independently correlated with nodal involvement. A risk scoring system was constructed using these two predictive factors. Tumor size and vascular invasion are predictors of nodal involvement. In addition, tumor size > 11.5 mm is used as a driving parameter of better-tailored treatment during pre-operative assessment. Data from prospective studies are needed to validate these results and to guide decision-making in r-NETs patients in clinical practice.
直肠神经内分泌肿瘤（r-NETs）是一种罕见肿瘤，完整切除后总体预后良好。然而，对于淋巴结清扫范围或广泛切除的禁忌症尚无共识。在本研究中，我们旨在确定与G1-G2级r-NETs患者淋巴结转移相关的预测因素。对来自意大利八个三级中心的G1-G2级r-NETs患者进行了回顾性分析。从1990年1月至2020年1月，共纳入210例患者，其中199例纳入分析。159例患者有淋巴结状态数据。淋巴结受累率为9%。进行了受试者工作特征（ROC）曲线分析，分别确定直径（>11.5 mm）和Ki-67（3.5%）作为预测淋巴结受累的临界值。在多因素分析中，直径>11.5 mm和血管浸润与淋巴结受累独立相关。利用这两个预测因素构建了风险评分系统。肿瘤大小和血管侵犯是淋巴结受累的预测因素。此外，肿瘤大小>11.5 mm在术前评估中用作更精准治疗的驱动参数。需要前瞻性研究的数据来验证这些结果，并指导r-NETs患者临床实践中的决策制定。
