Analysis on Prognosis Factors of Rectal Carcinoid_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

ZHU Jun , DING Jianhua , ZHAO Ke , TANG Haiyan

Department of Anorectal Surgery, The Gerneral Hospital of The Second Artillery of PLA, Center of Anorectal Diseaes of PLA, Beijing 100088, China;

Corresponding?author：

Keywords：

Rectal neoplasras; Carcinoid tumor; Pathology; Clinical

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Objective 　To investigate the clinicopathological characteristics and factors influencing the prognosis of rectal carcinoid.
Methods 　Clinical data of 31 cases with rectal careinoid, which identified diagnosis through operation and pathologic examination from January 2003 to March 2010 were retrospectively reviewed. Primary tumors were classified by size （≤1.0 cm， 1.0-2.0 cm， and ＞2.0 cm）and muscularis invasion respectively, compared therapeutic effect of different groups.
Results 　Median age of 31 cases was 49 years (22-83 years). Median follow-up time was 36 months (15-86 months), follow-up rate was 80.6% （25 /31）. During the follow-up period, there were no cases with recurrence among the 15 patients with tumor size≤l.0 cm, 1 case recurred in the 7 patients with turmor size between 1.0 cm to 2.0 cm, and 2 cases died from postoperative liver metastasis among the 3 patients with tumor size＞2.0 cm.There were relations between the tumor size, invasion depth, and metastasis （P＜0.05）. Metastasis and invasion depth of tumor were possibility increment to follow the aggrandizement of the diameter of rectal carcinoid.
Conclusion 　The diameter of rectal carcinoid and muscularis invasion may be important factors affecting survival, which may be an important basis for the choice of operative mode.

Citation： ZHU Jun,DING Jianhua,ZHAO Ke,TANG Haiyan,.. Analysis on Prognosis Factors of Rectal Carcinoid. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2012, 19(4): 387-390. doi: Copy

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2.	Scherübl H. Rectal carcinoids are on the rise：early detection by screening endoscopy [J]. Endoscopy， 2009， 41(2)： 162-165.
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6.	Maggard MA， O’Connell JB， Ko CY. Updated population-based review of carcinoid tumors [J]. Ann Surg， 2004， 240(1)： 117-122.
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8.	Jetmore AB， Ray JE， Gathright JB Jr， et a1. Rectal carcinoids：the most frequent carcinoid tumor [J]. Dis Colon Rectum， 1992，35(8)： 717-725.
9.	Modlin IM， Kidd M， Latich I， et a1. Current status of gastrointestinal carcinoids [J]. Gastroenterology， 2005， 128(6)： 1717-1751.
10.	Wang M， Peng J， Yang W， et a1. Prognostic analysis for carcinoid tumours of the rectum：a single institutional analysis of 106 patients [J]. Colorectal Dis， 2011， 13(2)： 150-153.
11.	Yoon SN， Yu CS， Shin US， et a1. Clinicopathological characteristics of rectal carcinoids [J]. Int J Colorectal Dis， 2010， 25(9)：1087-1092.
12.	Fahy BN， Tang LH， Klimstra D， et a1. Carcinoid of the rectum risk stratification (CaRRS)：a strategy for preoperative outcome assessment [J]. Ann Surg Oncol， 2007， 14(2)： 396-404．.
13.	Ono A， Fujii T， Saito Y， et a1. Endoscopic submucosal resection of rectal carcinoid tumors with a ligation device [J]. Gastrointest Endosc， 2003， 57(4)： 583-587．.
14.	周平紅，姚禮慶，鐘蕓詩，等. 直腸類癌的內鏡超聲診斷和內鏡黏膜下切除 [J]. 中華消化內鏡雜志， 2006， 23(3)： 175-178.
15.	Moon JH， Kim JH， Park CH， et a1. Endoscopic submucosal resection with double ligation technique for treatment of small rectal carcinoid tumors [J]. Endoscopy， 2006， 38(5)： 511-514．.
16.	Kwaan MR， Goldberg JE， Bleday R. Rectal carcinoid tumors：review of results after endoscopic and surgical therapy [J]. Arch Surg， 2008， 143(5)： 471-475．.
17.	張軼群，周平紅，徐美東，等. 內鏡治療直腸類癌的長期療效[J]. 中華胃腸外科雜志， 2008， 11(5)： 421-423．.
18.	Merg A， Wirtzfeld D， Wang J， et a1. Viability of endoscopic and excisional treatment of early rectal carcinoids [J]. J Gastrointest Surg， 2007， 11(7)： 893-897．.
19.	Kobayashi K， Katsumata T， Yoshizawa S， et a1. Indications of endoscopic polypectomy for rectal carcinoid tumors and clinical usefulness of endoscopic ultrasonography [J]. Dis Colon Rectum，2005， 48(2)： 285-291．.
20.	Ono H， Kondo H， Gotoda T， et a1. Endoscopic mucosal resection for treatment of early gastric cancer [J]. Gut， 2001， 48(2)：225-229．.
21.	Tamura S， Nakajo K， Yokoyama Y， et a1. Evaluation of endoscopic mucosal resection for laterally spreading rectal tumors [J].Endoscopy， 2004， 36(4)： 306-312．.
22.	Lee DS， Jeon SW， Park SY， et a1. The feasibility of endoscopic submucosal dissection for rectal carcinoid tumors：comparison with endoscopic mucosal resection [J]. Endoscopy， 2010，42(8)：647-651．.
23.	Park HW， Byeon JS， Park YS， et a1. Endoscopic submucosal dissection for treatment of rectal carcinoid tumors [J]. Gastrointest Endosc， 2010， 72(1)： 143-149．.
24.	Baek IH. Endoscopic submucosal dissection or conventional endoscopic mucosal resection is an effective and safe treatment for rectal carcinoid tumors：a retrospective study [J]. J Laparoendosc Adv Surg Tech A， 2010， 20(4)： 329-331．.
25.	Corman ML 著. 杜如昱，王杉，汪建平主譯. 結腸與直腸外科學 [M]. 北京：人民衛生出版社， 2009：968-970.
26.	Kim BN， Sohn DK， Hong CW， et a1. Atypical endoscopic features can be associated with metastasis in rectal carcinoid tumors[J]. Surg Endosc， 2008， 22(9)： 1992-1996．.
27.	Tsuboi K， Shimura T， Suzuki H， et a1. Liver metastases of a minute rectal carcinoid less than 5 mm in diameter：a case report [J]. Hepatogastroenterology， 2004， 51(59)： 1330-1332.

1. Modlin IM， Lye KD， Kidd M. A 5-decade analysis of 13 715 carcinoid tumors [J]. Cancer， 2003， 97(4)： 934-959.
2. Scherübl H. Rectal carcinoids are on the rise：early detection by screening endoscopy [J]. Endoscopy， 2009， 41(2)： 162-165.
3. Toth-Fejel S， Pommier RF. Relationships among delay of diagnosis，extent of disease， and survival in patients with abdominal carcinoid tumors [J]. Am J Surg， 2004， 187(5)： 575-579.
4. Soga J. Early-stage carcinoids of the gastrointestinal tract：an analysis of 1 914 reported cases [J]. Cancer， 2005， 103(8)：1587-1595.
5. 鐘蕓詩，周平紅，徐美東，等. 套扎器法內鏡黏膜下切除術治療直腸類癌患者三年療效評價 [J]. 中華醫學雜志， 2007，87(21)： 1452-1456．.
6. Maggard MA， O’Connell JB， Ko CY. Updated population-based review of carcinoid tumors [J]. Ann Surg， 2004， 240(1)： 117-122.
7. Kinoshita T， Kanehira E， Omura K， et a1. Transanal endoscopic microsurgery in the treatment of rectal carcinoid tumor [J]. SurgEndosc， 2007， 21(6)： 970-974.
8. Jetmore AB， Ray JE， Gathright JB Jr， et a1. Rectal carcinoids：the most frequent carcinoid tumor [J]. Dis Colon Rectum， 1992，35(8)： 717-725.
9. Modlin IM， Kidd M， Latich I， et a1. Current status of gastrointestinal carcinoids [J]. Gastroenterology， 2005， 128(6)： 1717-1751.
10. Wang M， Peng J， Yang W， et a1. Prognostic analysis for carcinoid tumours of the rectum：a single institutional analysis of 106 patients [J]. Colorectal Dis， 2011， 13(2)： 150-153.
11. Yoon SN， Yu CS， Shin US， et a1. Clinicopathological characteristics of rectal carcinoids [J]. Int J Colorectal Dis， 2010， 25(9)：1087-1092.
12. Fahy BN， Tang LH， Klimstra D， et a1. Carcinoid of the rectum risk stratification (CaRRS)：a strategy for preoperative outcome assessment [J]. Ann Surg Oncol， 2007， 14(2)： 396-404．.
13. Ono A， Fujii T， Saito Y， et a1. Endoscopic submucosal resection of rectal carcinoid tumors with a ligation device [J]. Gastrointest Endosc， 2003， 57(4)： 583-587．.
14. 周平紅，姚禮慶，鐘蕓詩，等. 直腸類癌的內鏡超聲診斷和內鏡黏膜下切除 [J]. 中華消化內鏡雜志， 2006， 23(3)： 175-178.
15. Moon JH， Kim JH， Park CH， et a1. Endoscopic submucosal resection with double ligation technique for treatment of small rectal carcinoid tumors [J]. Endoscopy， 2006， 38(5)： 511-514．.
16. Kwaan MR， Goldberg JE， Bleday R. Rectal carcinoid tumors：review of results after endoscopic and surgical therapy [J]. Arch Surg， 2008， 143(5)： 471-475．.
17. 張軼群，周平紅，徐美東，等. 內鏡治療直腸類癌的長期療效[J]. 中華胃腸外科雜志， 2008， 11(5)： 421-423．.
18. Merg A， Wirtzfeld D， Wang J， et a1. Viability of endoscopic and excisional treatment of early rectal carcinoids [J]. J Gastrointest Surg， 2007， 11(7)： 893-897．.
19. Kobayashi K， Katsumata T， Yoshizawa S， et a1. Indications of endoscopic polypectomy for rectal carcinoid tumors and clinical usefulness of endoscopic ultrasonography [J]. Dis Colon Rectum，2005， 48(2)： 285-291．.
20. Ono H， Kondo H， Gotoda T， et a1. Endoscopic mucosal resection for treatment of early gastric cancer [J]. Gut， 2001， 48(2)：225-229．.
21. Tamura S， Nakajo K， Yokoyama Y， et a1. Evaluation of endoscopic mucosal resection for laterally spreading rectal tumors [J].Endoscopy， 2004， 36(4)： 306-312．.
22. Lee DS， Jeon SW， Park SY， et a1. The feasibility of endoscopic submucosal dissection for rectal carcinoid tumors：comparison with endoscopic mucosal resection [J]. Endoscopy， 2010，42(8)：647-651．.
23. Park HW， Byeon JS， Park YS， et a1. Endoscopic submucosal dissection for treatment of rectal carcinoid tumors [J]. Gastrointest Endosc， 2010， 72(1)： 143-149．.
24. Baek IH. Endoscopic submucosal dissection or conventional endoscopic mucosal resection is an effective and safe treatment for rectal carcinoid tumors：a retrospective study [J]. J Laparoendosc Adv Surg Tech A， 2010， 20(4)： 329-331．.
25. Corman ML 著. 杜如昱，王杉，汪建平主譯. 結腸與直腸外科學 [M]. 北京：人民衛生出版社， 2009：968-970.
26. Kim BN， Sohn DK， Hong CW， et a1. Atypical endoscopic features can be associated with metastasis in rectal carcinoid tumors[J]. Surg Endosc， 2008， 22(9)： 1992-1996．.
27. Tsuboi K， Shimura T， Suzuki H， et a1. Liver metastases of a minute rectal carcinoid less than 5 mm in diameter：a case report [J]. Hepatogastroenterology， 2004， 51(59)： 1330-1332.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Analysis on Prognosis Factors of Rectal Carcinoid

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