Risk factors for residual tumors in histologically incompletely resected rectal neuroendocrine tumors

초록

Background: Rectal neuroendocrine tumors (r-NETs) are often misidentified as polyps, leading to inappropriate endoscopic treatment and incomplete resection. Aims: This study investigated the occurrence and risk factors of residual r-NETs following salvage local resection (SLR) after incomplete resection. Methods: The medical records of 95 patients who underwent SLR for histologically incompletely resected (R1/Rx-resected) r-NETs referred from other hospitals between January 2020 and August 2023 were analyzed. Results: The residual r-NET rate was 48.4 % (46/95), varying according to the primary resection method: cold forceps polypectomy (CFP), 70.0 % (21/30); conventional polypectomy or endoscopic mucosal resection (EMR), 41.7 % (25/60); and modified EMR or endoscopic submucosal dissection, 0 % (0/5). The residual r-NET rate was 65.7 % for endoscopically incomplete primary resection versus 0 % for endoscopically complete primary resection. Upon multivariate analysis, endoscopically suspected remnant tumors before SLR (odds ratio [OR], 15.56; 95 % confidence interval [CI], 2.94-82.35, p = 0.002) and the use of CFP for primary resection (OR, 3.60; 95 % CI, 1.02-14.52, p = 0.043) were associated with residual r-NETs after SLR. Conclusion: Salvage resection should be considered for R1/Rx-resected r-NET cases with risk factors for residual tumors to lower the likelihood of recurrence. (c) 2025 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights are reserved, including those for text and data mining, AI training, and similar technologies.

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