Srirajaskanthan Rajaventhan, Clement Dominique, Brown Sarah, Howard Mark R, Ramage John K
Kings Health Partners, ENETS Centre of Excellence, Institute of Liver Studies, King's College Hospital, London SE5 9RS, UK.
Department of Gastroenterology, King's College Hospital, London SE5 9RS, UK.
Cancers (Basel). 2023 May 15;15(10):2766. doi: 10.3390/cancers15102766.
Rectal neuroendocrine neoplasms are increasing in incidence, in part due to increased endoscopic procedures being performed for bowel cancer screening. Whilst most of these lesions are low-grade well-differentiated neuroendocrine tumours, they can have a varied clinical behaviour. Frequently, these lesions are incorrectly characterised at endoscopy and, therefore, incompletely excised using standard polypectomy techniques. Furthermore, some cases are not fully staged prior to or post resection. In this article we discuss the endoscopic and surgical options available to improve the likelihood of achieving an R0 resection and the staging procedures that should be used in these NETs. We also review factors that may suggest a higher risk of nodal involvement or recurrence. This information may help determine whether endoscopic or surgical resection techniques should be considered. In cases of R1 resection we discuss the management options available and the long-term surveillance options and when these should be offered to patients.
直肠神经内分泌肿瘤的发病率正在上升，部分原因是用于肠癌筛查的内镜检查程序增多。虽然这些病变大多是低级别、高分化神经内分泌肿瘤，但它们的临床行为可能各不相同。这些病变在内镜检查时常常被错误分类，因此，使用标准息肉切除术技术切除不完全。此外，一些病例在切除前或切除后没有进行全面分期。在本文中，我们讨论了可提高实现R0切除可能性的内镜和手术选择，以及这些神经内分泌肿瘤应采用的分期程序。我们还回顾了可能提示淋巴结受累或复发风险较高的因素。这些信息可能有助于确定是否应考虑采用内镜或手术切除技术。对于R1切除的病例，我们讨论了可用的管理选项、长期监测选项以及应在何时为患者提供这些选项。
