Endocrine Tumors

Annals of Surgical Oncology

, Volume 19, Issue 11, pp 3486-3490

Surveillance of Small Rectal Carcinoid Tumors in the Absence of Metastatic Disease

  • Sara E. MurrayAffiliated withSection of Endocrine Surgery, Department of Surgery, University of Wisconsin
  • , Rebecca S. SippelAffiliated withSection of Endocrine Surgery, Department of Surgery, University of Wisconsin
  • , Ricardo LloydAffiliated withDepartment of Pathology and Laboratory Medicine, University of Wisconsin
  • , Herbert ChenAffiliated withSection of Endocrine Surgery, Department of Surgery, University of Wisconsin Email author 

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Abstract

Background

The incidence of rectal carcinoids is rapidly increasing, typically presenting as small (<1.0 cm), localized tumors. Although the evaluation of rectal carcinoids on presentation is well standardized, surveillance after resection has not been well established.

Methods

A prospective database documented patients with rectal carcinoids at our institution between January 1995 and September 2011. Information collected included patient and tumor characteristics, treatment method, surveillance schedule, recurrence, and survival.

Results

Twenty-eight patients with rectal carcinoid were identified. Ten patients were excluded for tumors >1 cm, known metastases at presentation, <6 months follow-up, or previous resections. The mean age of the remaining patients was 56 ± 3 years, and 61 % of the patients were female. All patients were diagnosed at endoscopy, with 50 % diagnosed incidentally on screening endoscopy. Treatment methods included endoscopic therapy (n = 13, 72 %), transanal excision (n = 3, 17 %), and transanal endoscopic microsurgery (n = 1, 5.5 %). One patient (5.5 %) received no additional invasive therapy after diagnostic endoscopy. The mean tumor diameter was 4.6 ± 0.5 mm. The average length of follow-up was 5.4 ± 0.9 years, with a median number of 2 follow-up endoscopies (range 0–6). Two patients (11 %) died within the follow-up period from noncarcinoid causes. Importantly, no surviving patients developed local or distant recurrence with up to 12.3 years of follow-up.

Conclusions

On the basis of this experience, patients presenting with small (≤1.0 cm), nonmetastatic rectal carcinoids are unlikely to develop local or distant recurrence after resection. Aggressive surveillance with repeat endoscopies or other imaging studies after resection may be unnecessary in this patient population.