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Lymph-node metastases in rectal carcinoids

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Abstract

Background

Colorectal carcinoids are described as low-grade malignancy in the WHO classification. However, the survival is equally poor between carcinoids and adenocarcinomas if the tumors have lymph node metastasis or distant metastasis.

Patients and methods

We reviewed 17 patients with rectal carcinoid, who underwent surgical resection with lymph node dissection at our institution between March 2005 and November 2007. Our criteria for surgical resection were: tumor size of 10 mm or larger and positive resection margin or the presence of lymphovascular invasion in lesions to which endoscopic or surgical local treatment was carried out.

Results

Lymph node metastases were present in 12 patients. Three of them were with tumors less than 10 mm in size, of whom two patients had lymphovascular invasion. In eight out of the 12 with lymph node metastases, preoperative computed tomography (CT) identified lymph nodes of 5 mm or larger in size.

Conclusions

The present study demonstrated that rectal carcinoids with lymph node metastasis are common. Previously reported risk factors of lymph node metastasis in rectal carcinoid such as tumor size > = 10 mm and lymphovascular invasion are useful in predicting lymph node metastasis. In addition, lymph nodes 5 mm or larger in size identified on preoperative CT suggest the presence of metastasis.

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References

  1. Maggard MA, O’Connell JB, Ko CY (2004) Updated population-based review of carcinoid tumors. Ann Surg 240(1):117–122, doi:10.1097/01.sla.0000129342.67174.67

    Article  PubMed  Google Scholar 

  2. Kloppel G, Perren A, Heitz PU (2004) The gastroenteropancreatic neuroendocrine cell system and its tumors: the WHO classification. Ann N Y Acad Sci 1014:13–27

    Article  PubMed  Google Scholar 

  3. Konishi T, Watanabe T, Kishimoto J, Kotake K, Muto T, Nagawa H (2007) Prognosis and risk factors of metastasis in colorectal carcinoids: results of a nationwide registry over 15 years. Gut 56(6):863–868, doi:10.1136/gut.2006.109157

    Article  PubMed  Google Scholar 

  4. Fahy BN, Tang LH, Klimstra D, Wong WD, Guillem JG, Paty PB, Temple LK, Shia J, Weiser MR (2007) Carcinoid of the rectum risk stratification (CaRRs): a strategy for preoperative outcome assessment. Ann Surg Oncol 14(5):1735–1743, doi:10.1245/s10434-006-9311-6

    Article  PubMed  Google Scholar 

  5. Modlin IM, Kidd M, Latich I, Zikusoka MN, Shapiro MD (2005) Current status of gastrointestinal carcinoids. Gastroenterology 128(6):1717–1751, doi:10.1053/j.gastro.2005.03.038

    Article  PubMed  Google Scholar 

  6. Ramage JK, Davies AH, Ardill J, Bax N, Caplin M, Grossman A, Hawkins R, McNicol AM, Reed N, Sutton R, Thakker R, Aylwin S, Breen D, Britton K, Buchanan K, Corrie P, Gillams A, Lewington V, McCance D, Meeran K, Watkinson A (2005) Guidelines for the management of gastroenteropancreatic neuroendocrine (including carcinoid) tumours. Gut 54(Suppl 4):iv1–iv16

    Article  PubMed  Google Scholar 

  7. Kloppel G, Anlauf M (2005) Epidemiology, tumour biology and histopathological classification of neuroendocrine tumours of the gastrointestinal tract. Best Pract Res Clin Gastroenterol 19(4):507–517, doi:10.1016/j.bpg.2005.02.010

    Article  PubMed  Google Scholar 

  8. Shebani KO, Souba WW, Finkelstein DM, Stark PC, Elgadi KM, Tanabe KK, Ott MJ (1999) Prognosis and survival in patients with gastrointestinal tract carcinoid tumors. Ann Surg 229(6):815–821, doi:10.1097/00000658-199906000-00008

    Article  CAS  PubMed  Google Scholar 

  9. Mani S, Modlin IM, Ballantyne G, Ahlman H, West B (1994) Carcinoids of the rectum. J Am Coll Surg 179(2):231–248

    CAS  PubMed  Google Scholar 

  10. Soga J (2005) Early-stage carcinoids of the gastrointestinal tract: an analysis of 1914 reported cases. Cancer 103(8):1587–1595, doi:10.1002/cncr.20939

    Article  PubMed  Google Scholar 

  11. Modlin IM, Lye KD, Kidd M (2003) A 5-decade analysis of 13,715 carcinoid tumors. Cancer 97(4):934–959, doi:10.1002/cncr.11105

    Article  PubMed  Google Scholar 

  12. Koura AN, Giacco GG, Curley SA, Skibber JM, Feig BW, Ellis LM (1997) Carcinoid tumors of the rectum: effect of size, histopathology, and surgical treatment on metastasis free survival. Cancer 79(7):1294–1298, doi:10.1002/(SICI)1097-0142(19970401)79:7<1294::AID-CNCR4>3.0.CO;2-H

    Article  CAS  PubMed  Google Scholar 

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Correspondence to Yoshiya Fujimoto.

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Fujimoto, Y., Oya, M., Kuroyanagi, H. et al. Lymph-node metastases in rectal carcinoids. Langenbecks Arch Surg 395, 139–142 (2010). https://doi.org/10.1007/s00423-008-0438-8

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  • DOI: https://doi.org/10.1007/s00423-008-0438-8

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