1厘米及以下直肠1级神经内分泌肿瘤内镜下不完全切除后的长期预后

Long-term outcome of grade 1 rectal neuroendocrine tumor ≤1 cm after incomplete endoscopic resection.

作者信息

Park Jong Sun, Jeon Hye Lynn, Park Bumhee, Park Jong Hoon, Lee Gil Ho, Lim Sun Gyo, Shin Sung Jae, Lee Kee Myung, Noh Choong-Kyun

机构信息

Department of Gastroenterology, Ajou University School of Medicine, Suwon, Korea.

Department of Biomedical Informatics, Ajou University School of Medicine, Suwon, Korea.

出版信息

Clin Endosc. 2025 Jul 22. doi: 10.5946/ce.2025.043.

DOI:10.5946/ce.2025.043

PMID:40692298

Abstract

BACKGROUND/AIMS: Surveillance strategies for small grade 1 rectal neuroendocrine tumors (G1 rNETs) after incomplete endoscopic resection (ER) remain controversial. We evaluated the long-term outcomes of patients with G1 rNET ≤1 cm after ER who did and did not undergo complete resection.

METHODS

We retrospectively evaluated 441 patients with G1 rNETs measuring ≤1 cm after ER between 2011 and 2022. Patients were divided into complete and incomplete resection groups according to histopathological evaluation. Logistic regression analysis identified the risk factors for incomplete resection after ER.

RESULTS

The mean follow-up intervals were 38.6 and 45.7 months in all patients and the incomplete resection group, respectively. No recurrences were observed during the follow-up period. The mean lesion size was 5.5 mm and the complete resection rate was 80.5% (n=355). In the logistic regression analysis, lesion size 5.1 to 10 mm (odds ratio [OR], 2.3; 95% confidence interval [CI], 1.245-4.203; p=0.008), multiple lesions (OR, 8.3; 95% CI, 1.247-54.774; p=0.029), and retroflexion view during the procedure (OR, 4.0; 95% CI, 1.668-9.615; p=0.002) were independent risk factors for incomplete resection.

CONCLUSIONS

The prognosis of G1 rNET ≤1 cm after ER was very good, regardless of the histopathological results.

摘要

背景/目的：小的1级直肠神经内分泌肿瘤（G1 rNETs）在内镜下切除不完全（ER）后的监测策略仍存在争议。我们评估了ER后G1 rNET≤1 cm且进行和未进行完整切除的患者的长期结局。

方法

我们回顾性评估了2011年至2022年间ER后G1 rNETs≤1 cm的441例患者。根据组织病理学评估将患者分为完整切除组和不完全切除组。逻辑回归分析确定了ER后不完全切除的危险因素。

结果

所有患者和不完全切除组的平均随访间隔分别为38.6个月和45.7个月。随访期间未观察到复发。平均病变大小为5.5 mm，完整切除率为80.5%（n = 355）。在逻辑回归分析中，病变大小5.1至10 mm（比值比[OR]，2.3；95%置信区间[CI]，1.245 - 4.203；p = 0.008）、多发病变（OR，8.3；95% CI，1.247 - 54.774；p = 0.029）和手术过程中的反转观察（OR，4.0；95% CI，1.668 - 9.615；p = 0.002）是不完全切除的独立危险因素。