Neuroendocrine Tumor of the Colon and Rectum: Results of 9-year Single-Institute Experience

結腸及直腸神經內分泌腫瘤：單一醫療機構九年經驗

張家齊(Chia-Chi Chang) ； 陳嘉哲(Chia-Che Chen) ； 郭立人(Li-Jen Kuo)

《中華民國大腸直腸外科醫學會雜誌》 29卷4期 (2018/12) Pp. 159-167

https://doi.org/10.6312/SCRSTW.201812_29(4).10701

摘要

Purpose. To review the experience of a single hospital in treating neuroendocrine tumors (NETs) of the colon and rectum. Methods. This retrospective chart review evaluated the diagnosis, treatment, and survival of patients with colorectal NET treated by Taipei Medical University Hospital, Taiwan from January 2008 to March 2016. Post-treatment follow-up (through January 2017) was accomplished through regular outpatient check-ups and telephone calls. Results. Sixty-eight patients were characterized in this study; 38 were treated using endoscopic mucosal resection (EMR), 20 received transanal resection, and 10 had laparoscopic anterior resection (LAR). In the EMR group, majority of tumors were low tumor grade (84.21%), and AJCC pathology stage I/II tumors (100%). Compared with the EMR and transanal groups, the LAR group had higher AJCC stage (70% of patients had stage III/IV AJCC pathology stage). In addition, patients treated with LAR had the largest tumor size (22.4 mm) followed by transanal resection (5.7 mm) and EMR (5.39 mm). Survival rates that were ≥ 90% did not significantly differ across surgical procedure groups (p = 0.198). Conclusions. NETs are rare in the colon or rectum. Results of the present retrospective chart review reveal the main factor affecting NET-bearing patients' survival is early tumor detection and treatment of choice.

關鍵字

Neuroendocrine tumors ； Colon ； Rectum ； Retrospective review

並列摘要

目的：回顧及研究單一醫療機構治療結腸及直腸神經內分泌腫瘤的經驗。方法：這是一篇回顧性的研究，針對結腸及直腸神經內分泌腫瘤的病人在台北醫學大學附設醫院從西元2008年一月到西元2016年三月，診斷、治療及預後的病歷分析。治療後的追蹤則是藉由門診及電話訪視，一直持續到西元2017年一月。成果：研究總共納入68位病人：其中38位接受內視鏡黏膜切除術、20位接受經肛門腫瘤切除手術、10位接受腹腔鏡前位切除手術。在內視鏡黏膜切除術組，大部分的腫瘤(84.21%)屬於低分化度，美國癌症協會(AJCC)癌症分期第一期及第二期 (100%)。比較內視鏡黏膜切除術及經肛門腫瘤切除手術的病人，接受腹腔鏡前位切除手術的病人有較高的美國癌症協會(AJCC)癌症分期（70%的病人屬於第三期或第四期）。除此之外，接受腹腔鏡前位切除手術的病人，比起其它兩組病人有較大的腫瘤大小（腹腔鏡前位切除手術腫瘤大小22.4 mm、經肛門腫瘤切除手術腫瘤大小5.7 mm、內視鏡黏膜切除術腫瘤大小5.39 mm）。關於存活率大於90%的病人，分析起來跟手術的方式並沒有顯著意義。結論：神經內分泌腫瘤在結腸和直腸中很少見，這篇回顧性研究的結果顯示，主要影響結腸及直腸神經內分泌腫瘤病人的預後因子為早期發現及治療的選擇。

並列關鍵字

神經內分泌腫瘤 ； 內視鏡黏膜切除術 ； 經肛門腫瘤切除手術 ； 腹腔鏡前位切除手術

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