We found a match
Your institution may have rights to this item. Sign in to continue.
- Title
The Ki-67 labeling index and lymphatic/venous permeation predict the metastatic potential of rectal neuroendocrine tumors.
- Authors
Sugimoto, Shinya; Hotta, Kinichi; Shimoda, Tadakazu; Imai, Kenichiro; Yamaguchi, Yuichiro; Nakajima, Takashi; Oishi, Takuma; Mori, Keita; Takizawa, Kohei; Kakushima, Naomi; Tanaka, Masaki; Kawata, Noboru; Matsubayashi, Hiroyuki; Ono, Hiroyuki
- Abstract
<bold>Background: </bold>Endoscopic resection has been used to treat small rectal neuroendocrine tumors (NETs). However, the indication for additional surgery after endoscopic resection is unclear. The aim of this study was to identify risk factors for rectal NET metastasis and to determine the indication for additional surgery.<bold>Methods: </bold>Fifty-five patients with a total of 57 rectal NETs, treated between October 2003 and January 2013, were retrospectively divided into metastatic (11 lesions) and non-metastatic (46 lesions) groups. Tumor size, central depression, invasion depth, lymphatic and venous permeation, mitotic activity, nuclear abnormality, Ki-67 labeling index, and World Health Organization grading classification (G1 or G2) were compared between the groups. Patients underwent endoscopic submucosal resection with a ligation device, transanal full-thickness surgical resection, or radical surgery.<bold>Results: </bold>By univariate analysis, the odds ratios (OR) for a Ki-67 labeling index >3.0 %, positive lymphatic or venous permeation, World Health Organization grading classification G2, tumor size >10 mm, submucosal invasion >4000 μm, and central depression were 120 (P < 0.001), 67.6 (P < 0.001), 58.7 (P < 0.001), 9.8 (P = 0.0037), 6.8 (P = 0.012), and 5.7 (P = 0.018), respectively. Multivariate logistic regression analyses showed that vascular permeation (OR 111; P = 0.006) and a Ki-67 labeling index >3.0 % (OR 88; P = 0.012) were independent risk factors for metastasis.<bold>Conclusions: </bold>The Ki-67 labeling index and lymphatic/venous permeation were reliable predictors of rectal NET metastases.
- Subjects
NEUROENDOCRINE tumors; ENDOSCOPIC surgery; LAPAROSCOPIC surgery; LOGISTIC regression analysis; LYMPHATIC diseases; ANTHROPOMETRY; CANCER invasiveness; CYTOGENETICS; ENDOSCOPY; SURGICAL excision; LIVER tumors; LYMPH node surgery; LYMPHATICS; METASTASIS; MULTIVARIATE analysis; PROGNOSIS; RECTUM tumors; TUMOR markers; VEINS; RETROSPECTIVE studies; CASE-control method; ODDS ratio; TUMOR grading
- Publication
Surgical Endoscopy & Other Interventional Techniques, 2016, Vol 30, Issue 10, p4239
- ISSN
1866-6817
- Publication type
journal article
- DOI
10.1007/s00464-015-4735-3