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Predictive Factors for Lymph Node Metastasis and Prognostic Factors for Survival in Rectal Neuroendocrine Tumors

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Journal of Gastrointestinal Surgery Aims and scope

Abstract

Introduction

Neuroendocrine tumors have malignant potential, and lymph node metastasis can occur. This study aimed to identify predictive factors of lymph node metastasis and prognostic factors for survival in rectal neuroendocrine tumors.

Methods

Sixty-four patients underwent endoscopic or surgical treatment for rectal NET. The data on these patients were collected in our database prospectively and reviewed retrospectively.

Results

Transanal excision was performed in 28 (43.8%) patients, endoscopic mucosal resection or submucosal dissection was performed in 15 (23.4%) patients, and radical resection was performed in 21 (31.8%) patients. Lymph node and distant metastasis was present in 16 (25.0%) and fir (7.8%) patients. The significant risk factors for lymph node metastasis identified in the multivariable analyses were tumor size (≥ 2 cm, p = 0.003) and tumor grade (G2, p < 0.001; G3, p = 0.008). In patients with a tumor smaller than 2 cm, the risk factors for lymph node metastasis included the tumor grade, mitosis count, and Ki-67 index. The median follow-up period was 30.0 months, and recurrence developed in four (6.8%) patients. The significant prognostic factors for survival included tumor size, T stage, lymph node metastasis, and tumor grade.

Conclusion

Tumor grade combined with tumor size is an important predictive factor for lymph node metastasis and could serve as a prognostic factor for survival outcomes.

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Acknowledgements

Beonghoon Sohn and Yoomin Kwon contributed equally. The authors thank the members of the Medical Research Collaborating Center (MRCC) at Seoul National University Hospital for assistance with the statistical analysis.

Authorship

Sohn B, Kwon Y, and Ryoo SB designed the study and drafted the manuscript; B Sohn, Kwon Y, Ryoo SB, Song I, Kwon YH, Lee DW, Moon SH, Park JW, Jeong SY, and Park KJ conducted the research; Sohn B, Kwon Y, and Ryoo SB collected and analyzed the data; and B Sohn, Kwon Y, Ryoo SB, Song I, Kwon YH, Lee DW, Moon SH, Park JW, Jeong SY, and Park KJ reviewed and modified the manuscript.

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Authors and Affiliations

  1. Department of Surgery, Seoul National University College of Medicine, 101 Daehak-ro (28 Yeongeon-dong), Jongno-Gu, Seoul, 03080, Korea

    Beonghoon Sohn, Yoomin Kwon, Seung-Bum Ryoo, Inho Song, Yoon-Hye Kwon, Dong Woon Lee, Sang Hui Moon, Ji Won Park, Seung-Yong Jeong & Kyu Joo Park

  2. Colorectal Cancer Center, Seoul National University Cancer Hospital, Seoul, 03080, Korea

    Seung-Bum Ryoo, Ji Won Park, Seung-Yong Jeong & Kyu Joo Park

  3. Cancer Research Institute, Seoul National University, Seoul, 03080, Korea

    Ji Won Park & Seung-Yong Jeong

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  1. Beonghoon Sohn
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  2. Yoomin Kwon
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  3. Seung-Bum Ryoo
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Correspondence to Seung-Bum Ryoo.

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Sohn, B., Kwon, Y., Ryoo, SB. et al. Predictive Factors for Lymph Node Metastasis and Prognostic Factors for Survival in Rectal Neuroendocrine Tumors. J Gastrointest Surg 21, 2066–2074 (2017). https://doi.org/10.1007/s11605-017-3603-y

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