Clinical Observation after Resection of Lower Gastrointestinal Carcinoid Tumor

Goo, Ja Chung; Kim, Byeong Uk; Jeong, Jee In; Han, Joung Ho; Chae, Hee Bok; Park, Seon Mee; Youn, Sei Jin; Lee, Ho Chang

Abstract

BACKGROUND/AIMS
The increase of colonoscopy procedures has led to an increase in the diagnosis of carcinoid tumors in the lower gastrointestinal tract. The purpose of this study was to identify the clinical and pathological characteristics that affect the treatment and recurrence of carcinoid tumors of the lower gastrointestinal tract.
METHODS
A 10-year (1999-2009) retrospective analysis of 41 patients with carcinoid tumors of the lower gastrointestinal tract at the Chungbuk National University Hospital was conducted. Patient and tumor characteristics, treatment and recurrence were analyzed.
RESULTS
The mean age was 47.4+/-12.4 (range, 22-79 years) and the male to female ratio was 1:0.64. The mean tumor size was 9.4+/-4.8 (3-20) mm. In the lower gastrointestinal tract, the rectum was the most frequent location of the lower gastrointestinal carcinoid tumors (92.7%). Twenty-nine out of 41 patients were treated by endoscopy (mean size of tumor: 8.0+/-3.4 mm) and 12 were treated by surgery (mean size of tumor: 13.8+/-5.8 mm)(P=0.011). Among the patients treated by endoscopy, only one patient had a complete resection. However, the histology showed that 10 patients treated by endoscopy had positive resection margins; all 10 cases (35.7%) had a polypectomy (P=0.013). The mean follow-up duration was 19.2+/-14.5 months, and there were two recurrences of rectal carcinoid tumors.
CONCLUSIONS
Both endoscopic and surgical resections were effective methods for the treatment of lower gastrointestinal carcinoid tumors. However, endoscopic polypectomy should be carefully considered because of the possibility of more frequent incomplete histological resections. Moreover, even for small rectal carcinoid tumors, follow-up examination should be performed to evaluate for tumor recurrence.