Prevalence of metastasis and survival of 788 patients with T1 rectal carcinoid tumors

Saowanee Ngamruengphong, Ayesha Kamal, Venkata Akshintala, Gulara Hajiyeva, Yuri Hanada, Yen I. Chen, Omid Sanaei, Daniela Fluxa, Yamile Haito Chavez, Vivek Kumbhari, Vikesh Singh, Anne Marie O'Broin-Lennon, Marcia Canto, Mouen Khashab

Research output: Contribution to journalArticle

Abstract

Background and Aims: Prevalence of rectal carcinoids is increasing, partly because of increased colorectal cancer screening. Local excision (endoscopic or transanal excision) is usually performed for small (<1-2 cm) rectal carcinoids, but data on clinical outcomes from large population-based U.S. studies are lacking. The aims of this study were to determine the prevalence of metastasis of resected small rectal carcinoid tumors using a large national cancer database and to evaluate the long-term survival of patients after local resection as compared with radical surgery. Methods: The Surveillance Epidemiology and End Results database was used to identify 788 patients with rectal T1 carcinoids <2 cm in size. Prevalence of metastases at initial diagnosis and risk factors for metastases were analyzed. Cancer-specific survival (CSS) was calculated. Results: A total of 727 patients (92.3%) had tumors ≤10 mm in diameter and 61 (7.7%) had tumors 11 to 19 mm. Overall, 12 patients (1.5%) had metastasis at the time of diagnosis with prevalence of 1.1% in lesions ≤10 mm and 6.6% in lesions 11 to 19 mm (P =.01). Survival of patients with T1 rectal carcinoids without metastasis was significantly better than those with metastasis (5-year CSS of 100% vs 78%, P <.001). Of 559 patients with T1N0M0 rectal carcinoids ≤10 mm, 5-year CSS was 100% in both groups who underwent local excision and those who underwent radical surgery. Conclusions: Larger T1 rectal carcinoid tumors (11-19 mm) have significantly higher risk of lymph node metastases compared with those ≤10 mm. Survival is worse with metastatic disease. Local therapy is adequate for T1N0M0 rectal carcinoids ≤10 mm in size with excellent long-term outcomes.

Original languageEnglish (US)
Pages (from-to)602-606
Number of pages5
JournalGastrointestinal endoscopy
Volume89
Issue number3
DOIs
Publication statusPublished - Mar 1 2019

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ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Gastroenterology

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