Endoscopic, transanal, laparoscopic, and transabdominal management of rectal neuroendocrine tumors

Publication date: Available online 9 July 2019Source: Best Practice & Research Clinical Endocrinology & MetabolismAuthor(s): Louis de Mestier, Diane Lorenzo, Caroline Fine, Jérôme Cros, Olivia Hentic, Thomas Walter, Yves Panis, Anne Couvelard, Guillaume Cadiot, Philippe RuszniewskiAbstractRectal neuroendocrine tumors (RNET) are rare tumors but their prevalence is constantly increasing due to a prolonged survival and rising incidence related to a growing number of colonoscopies and improved knowledge. Their main prognostic determinant is tumor stage. While most RNET are localized, their management should be tailored depending on the presence or absence of the factors predictive of lymph-node metastases including tumor size, endoscopic aspect, T stage, grade and lymphovascular invasion. Endoscopic ultrasonography is the most relevant technique for locoregional assessment. Low-risk RNET can be treated using advanced endoscopic resection techniques or transanal endoscopic microsurgery, in expert centers because they require technicity and experience. Conversely, radical surgery with lymphadenectomy should be proposed in the presence of any pejorative factor. The long-term evolution of RNET remains to be specified, and prospective studies should be conducted in order to determine the relevance of the current management strategies.

Source: Best Practice and Research Clinical Endocrinology and Metabolism - July 10, 2019 Category: Endocrinology Source Type: research