Clinicopathological characteristics of rectal carcinoids
ABSTRACT Carcinoids are heterogeneous neuroendocrine tumors with malignant potential. The rectum is the third most common location for gastrointestinal carcinoids. We assessed the clinicopathological characteristics of rectal carcinoids.
A retrospective study of 203 patients treated for rectal carcinoids at the Asan Medical Center, Seoul, Republic of Korea from 1991 to 2007.
The patients were on average 51 (18-83) years old. The male-to-female ratio was 1.48:1. Over half (62.1%) of the patients were asymptomatic. The most frequent symptoms in the symptomatic patients were abdominal pain (11.1%) and hematochezia (10.7%). Local excision was applied to 92.1%, low anterior resection to 4.9%, and biopsy only to 3.0% of total patients. Initially, 4.4% presented with distant metastasis. Distant metastasis rates for tumors < or =1 cm, >1 to < or =2 cm, and >2 cm were 1.7% (3/177), 15.0% (3/20), and 50.0% (3/6), respectively. In the follow-up period, three patients showed recurrences. The size, lymphovascular invasion, perineural invasion, and T and N stages were associated with distant metastasis. The overall 5-year survival rate was 94.0%. The TNM stage and presence of lymphovascular invasion were associated with lower survival.
The chance that a rectal carcinoid will develop distant metastases increases as the tumor increases in size, lymphovascular invasion or perineural invasion is present, and T and N stages increase. The TNM stage and presence of lymphovascular invasion were associated with lower survival. Treatment plan should be chosen carefully considering above factors.
SourceAvailable from: Zubaida Rasool[Show abstract] [Hide abstract]
ABSTRACT: Background: Aim of current study was to study the histopathological spectrum of neoplastic lesions of large intestine and histopathological pattern of colorectal carcinoma in young adults. Methods: We took a combined retrospective & prospective study in the department of pathology. The specimens were collected from subjects diagnosed as colorectal carcinomas in histopathology department and clinical details were sought from the medical records. Variables like age, sex, dietary habit, relevant history, tumor size, location, type of lesion, histological pattern of patients were checked. Results: In the series of 446 patients of colorectal neoplasm, maximum number of patients presented in 4th to 6th decade of life (47.30%), while as (15.46%) were between 20-40 years. The youngest patient with an adenocarcinoma was 18 years (male) of age and the oldest one was 80 years (male) of age. Average age of patients was 50.50 years. The male to female ratio was 1.3:1. The study revealed that the carcinoma of ascending colon was much more prevalent, constituting 107 (40.07%) cases. The proportion of well differentiated carcinoma was highest in left side colon and rectum. The incidence of moderately differentiated and poorly differentiated carcinoma was greater on right side colon. Conclusion: Adenocarcinoma is the most common histological variant of colon carcinomas.11/2014; 2(3):1097-1100. DOI:10.5455/2320-6012.ijrms20140890
[Show abstract] [Hide abstract]
ABSTRACT: Rectal carcinoids are an uncommon entity comprising only 1%-2% of all rectal tumors. Rectal carcinoids are frequently diagnosed during colonoscopy, but management after polypectomy is still controversial. The aims of this study were to review the surgical procedures for rectal carcinoids and to compare the outcomes of patients after different treatment modalities in a university hospital in Hong Kong. All rectal carcinoids diagnosed between January 2003 and September 2012 were reviewed retrospectively, including clinicopathological characteristics, their management, and surgical outcomes. There were 54 patients with a median age of 60 years, and 32 were males (59.3%). All patients underwent colonoscopy, and the most had rectal bleeding (53.7%). Two patients were diagnosed incidentally in the surgical specimens of rectal tissues. Eighteen patients were diagnosed to have rectal carcinoids after snaring polypectomy, and no further intervention was required. Twenty-five patients had local resection either by means of transanal resection or transanal endoscopic operation. Radical resection was performed in seven patients in which one had T3N1 disease and the others did not have any lymph node metastasis. In the median follow-up of 30 months (10-108 months), there was no recurrence in the "incidental" or post-polypectomy group. However, two patients with transanal resection and two patients with radical resection developed hepatic metastases after 13-24 months post-treatment. The 5-year overall survival was 100% in patients having snaring polypectomy only, 83% for those with local resection, and 63% in patients who underwent radical surgery (p = 0.04). Our data suggested that that local resection was an effective treatment for small rectal carcinoids and generally brought about good oncological and surgical outcomes. For larger tumors, radical resection seemed to provide acceptable oncological outcomes. Regular surveillance with colonoscopy and endorectal ultrasound is highly recommended for high-risk patients for long-term management. By sharing our experience, we hope to provide more evidence on the management on rectal carcinoids which, together with evidence from further studies, may guide us in the long-term management of these patients in the future.World Journal of Surgical Oncology 12/2015; 13(1). DOI:10.1186/s12957-015-0463-3 · 1.20 Impact Factor
[Show abstract] [Hide abstract]
ABSTRACT: Colorectal carcinoid tumors are often described as being low-grade malignant. The objective of the current study was to address the clinicopathological features and outcomes of patients with colorectal carcinoid tumors. A total of 63 patients with colorectal carcinoid tumors were identified and evaluated using surgical pathology files and medical records between January 2000 and June 2012 at the Veterans General Hospital, Taipei, Taiwan. The median age of the 63 patients was 57.0 years; 38 (60.3%) were male and 25 (39.7%) female. The rectum was the most common tumor site (90.5%). Tumor size was 10.8 +/- 7.4 mm, ranging from 2 to 50 mm in diameter. There were 40 patients (63.5%) who received endoscopic treatment for a tumor size of 7.7 +/- 4.0 mm, 15 (23.8%) who underwent transanal excision for a mean size of 9.2 +/- 4.5 mm and eight (12.7%) who underwent radical surgical resection (mean size: 29.5 +/- 13.0 mm). Lymph node metastasis was significantly associated with tumor size. Totally distant metastases (liver) were demonstrated in four (6.3%), patients with mean tumor size of 31.3 +/- 9.4 mm (20 to 50 mm). The extent of the disease was associated with survival and the five-year overall survival rate was 92.1%. With widespread colorectal cancer screening, heightened awareness and improved diagnostic modalities, the incidence of colorectal carcinoid tumors will continue to increase. We demonstrated that small-sized colorectal carcinoid tumors and those localized in the mucosa or submucosa may be safely and effectively removed via endoscopic or transanal local excision.World Journal of Surgical Oncology 11/2014; 12(1):366. DOI:10.1186/1477-7819-12-366 · 1.20 Impact Factor