The Outcomes of Modified Endoscopic Mucosal Resection and Endoscopic Submucosal Dissection for the Treatment of Rectal Neuroendocrine Tumors and the Value of Endoscopic Morphology Classification in Endoscopic Resection

Overview

Journal BMC Gastroenterol

Publisher Biomed Central

Specialty Gastroenterology

Date 2020 Jun 27

PMID 32586282

Citations 12

Authors

Xiang-Yao Wang

Ning-Li Chai

En-Qiang Linghu

Shao-Tian Qiu

Long-Song Li

Jia-Le Zou

Jing-Yuan Xiang

Xing-Xing Li

Affiliations

Soon will be listed here.

Abstract

Background: To compare the outcomes of modified endoscopic mucosal resection (m-EMR) and endoscopic submucosal dissection (ESD) for rectal neuroendocrine tumors (NETs) and evaluate the value of endoscopic morphology classification in endoscopic resection (ER).

Methods: Patients with rectal NET diameters less than 2 cm who were treated between April 2007 and January 2019 were enrolled. The endoscopic morphology of rectal NETs was classified based on the endoscopic views. Patients who underwent ESD and m-EMR were compared. Baseline characteristics as well as en bloc resection, complete resection, the procedure time, adverse events and the risk factors associated with incomplete resection were analyzed.

Results: A total of 429 patients with 449 rectal NETs were enrolled for the classification of endoscopic morphology and were classified into four types (Ia, IIb, II, and III). There were 79 patients in the m-EMR group and 259 patients in the ESD group before matching. Propensity score matching created 77 pairs between the two groups that were well balanced. The mean procedure time was significantly shorter for m-EMR than for ESD (9.1 ± 4.4 min vs 16.0 ± 7.9 min, P = 0.000). The rates of en bloc resection (98.7% vs 100%; P = 1.000), complete resection (90.9% vs 93.5%, P = 0.548) and adverse events (2.6% vs 2.6%, P = 1.000) were similar between the two groups. Univariate and multivariate analyses showed that histopathological grade and endoscopic morphology were associated with incomplete resection.

Conclusion: Both ESD and m-EMR are effective and safe for the treatment of rectal NETs. Endoscopic morphology should be considered along with histopathological grade for ER.

Citing Articles

Endoscopic features of gastric neuroendocrine tumors.

Matsueda K, Uedo N, Kitamura M, Kanesaka T, Morita M, Shichijo S DEN Open. 2025; 5(1):e70088.

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Efficacy analysis of modified double band ligation-assisted endoscopic submucosal resection and endoscopic mucosal dissection in the treatment of gastric gastrointestinal stromal tumors (≤ 1.5 cm).

Fan X, Cai X, Jiao J, Luo L, Maihemuti A, Wang T Surg Endosc. 2025; .

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Comparison of endoscopic submucosal dissection and modified endoscopic mucosal resection for rectal neuroendocrine tumors.

Kitagawa Y, Suzuki T, Miyakawa A, Okimoto K, Matsumura T, Shiratori T Sci Rep. 2025; 15(1):5424.

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Comparative Efficacy and Acceptability of Endoscopic Methods for Rectal Neuroendocrine Neoplasms with Low Malignant Potential: A Network Meta-analysis.

Zhang S, Chen Q, Zhang Y, Li Q, Gao Y, Meng W Turk J Gastroenterol. 2024; 35(6):440-452.

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Gastroenteropancreatic neuroendocrine neoplasms: current development, challenges, and clinical perspectives.

Zhang X, Fan Y, Jing R, Getu M, Chen W, Zhang W Mil Med Res. 2024; 11(1):35.

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