Background Studies on grade 2 rectal neuroendocrine tumors are limited,and the optimal treatment for these tumors is not well established.Objective We aimed to compare the oncologic results of local excision versus radi-cal resection for the treatment of grade 2 rectal neuroendocrine tumors.Design Retrospective multicenter propensity score-matched study to minimize heterogeneity between groups and focus on the differences between surgery strategies.Settings Seventeen large-scale Chinese medical centers participated in this study.Patients A total of 144 patients with pathologically confirmed grade 2 rectal neuroendocrine tumors were retrospectively analyzed.Main outcome measures Cancer-specific survival and relapse-free survival were assessed to compare surgery strategies.Results A total of 144 pa-tients with grade 2 rectal neuroendocrine tumors were enrolled in this study.Twenty-seven patients underwent endo-scopic resection,55 underwent transanal excision,50 underwent radical resection,and 12 underwent palliative surgery or biopsy for distant metastasis.Of the 50 patients who underwent radical resection,30(60.0％)had clinically positive lymph nodes on the basis of the histopathology results.The optimal cutoff value for tumor size to predict cancer-specific survival was 1.5 cm.In patients with grade 2 rectal neuroendocrine tumors of≤1.5 cm size,there were no sig-nificant differences in cancer-specific survival and relapse-free survival between local excision and radical resection groups(P＞0.05).In patients with grade 2 rectal neuroendocrine tumors of＞1.5 cm size,relapse-free survival was sig-nificantly lower in the local excision group than in the radical resection group(P=0.04).Limitations The nature of ret-rospective reviews and a relatively short follow-up period are limitations of this study.Conclusions Grade 2 rectal neu-roendocrine tumors have a nonnegligible rate of lymph node metastasis.Local excision is a feasible choice for tumors of ≤1.5 cm size without metastasis,whereas radical resection is more beneficial in those of＞1.5 cm size.
关键词
局部切除术/淋巴结转移/根治性切除术/直肠神经内分泌肿瘤
Key words
local excision/lymph node metastasis/radical resection/rectal neuroendocrine tumors
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