Clinical Analysis of 130 Cases of Rectal Neuroendocrine Neoplasia

  Objective  The aim of this study was to analyze the factors affecting the prognosis of rectal neuroendocrine neoplasia (NEN).

  Methods  The clinical data were retrospectively collected in patients with rectal NEN who were diagnosed and surgically treated in the Department of General Surgery at Peking Union Medical College Hospital from May 2012 to September 2019. Patients suffering from distant organ metastases and rectal adenocarcinoma at the initial diagnosis were excluded. Kaplan-Meier analysis was used to assess the influence of general information, surgical methods, pathology, etc. on the disease-free survival.

  Results  A total of 130 patients with rectal NEN were enrolled, and 102 patients had a clear WHO classification. Among them, G1, G2, and G3 had 82, 18, and 2 patients, respectively. A total of 122 patients underwent local resection and 9 patientsunderwent radical surgery. One patient underwent remedial radical surgery after local resection. Lymph node metastasis was found in 7 patients, and all of them underwent radical surgery. Follow-up was performed on 116 patients, 4 of whom had recurrence or metastasis, and 2 died of NEN metastasis. Kaplan-Meier analysis showed that patients with radical surgery, lesions ≥ 2 cm, and lymph node metastasis had a lower rate of recurrence-free survival(all P < 0.05).

  Conclusions  Patients with rectal NEN who had a lesion ≥ 2 cm or metastatic lymph nodes may have a poorer prognosis. Radical surgery should be actively performed for these patients after cautious evaluation to exclude distant metastases, and a close follow-up should also be performed after surgery.