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Endoscopic management of 345 small rectal neuroendocrine tumours: A national study from the French group of endocrine tumours (GTE)

Caroline Fine 1 Guillaume Roquin 2 Eric Terrebonne 3 Thierry Lecomte 4, 5 Romain Coriat 6 Christine Do Cao 7 Louis de Mestier 8 Elise Coffin 9, 10 Guillaume Cadiot 11 Patricia Nicolli 12 Vincent Lepiliez 13 Vincent Hautefeuille 14 Jeanne Ramos 15 Paul Girot 16 Sophie Dominguez 17 Fritz-Line Céphise 18 Julien Forestier 19 Valerie Hervieu 20, 1 Mathieu Pioche 21, 1 Thomas Walter 22, 1
Abstract : INTRODUCTION: Small rectal neuroendocrine tumours are good candidates for endoscopic resection provided that complete pathological resection (R0) is obtained and their risk of metastatic progression is low. We conducted a large multicentre nationwide study to evaluate the outcomes of the management of non-metastatic rectal neuroendocrine tumours ≤2 cm diagnosed endoscopically. PATIENTS AND METHODS: The medical records, the endoscopic and pathological findings of patients with non-metastatic rectal neuroendocrine tumours ≤2 cm managed from January 2000-June 2018 in 16 French hospitals, were retrospectively analysed. The primary objective was to describe the proportion of R0 endoscopic resections. RESULTS: A total of 329 patients with 345 rectal neuroendocrine tumours were included, 330 (96%) tumours were managed by local treatments: 287 by endoscopy only and 43 by endoscopy followed by transanal endoscopic microsurgery. The final endoscopic R0 rate was 134/345 (39%), which improved from the first endoscopy (54/225, 24%), to the second (60/100, 60%) and the third endoscopy (20/26, 77%). R0 was associated with endoscopic technique (90% for advanced techniques, 40% for mucosectomy and 17% for polypectomy), but not with tumour or patient characteristics. Twenty patients had metastatic disease, which was associated with tumour size ≥10 mm (odds ratio: 9.1, 95% confidence interval (3.5-23.5)), tumour grade G2-G3 (odds ratio: 4.2, (1.5-11.7)), the presence of muscular (odds ratio: ∞, (11.9-∞)) and lymphovascular invasion (odds ratio: 57.2, (5.6-578.9)). CONCLUSIONS: The resection of small rectal neuroendocrine tumours often requires multiple procedures. Training of endoscopists is necessary in order to better recognise these tumours and to perform the appropriate resection technique.
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Contributeur : Nathalie Salvy-Cordoba <>
Soumis le : mardi 21 avril 2020 - 11:39:49
Dernière modification le : vendredi 15 mai 2020 - 12:22:04

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Caroline Fine, Guillaume Roquin, Eric Terrebonne, Thierry Lecomte, Romain Coriat, et al.. Endoscopic management of 345 small rectal neuroendocrine tumours: A national study from the French group of endocrine tumours (GTE). United European Gastroenterology Journal, SAGE Publications, 2019, 7 (8), pp.1102-1112. ⟨10.1177/2050640619861883⟩. ⟨hal-02549178⟩



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