Clinical significance of positive resection margin for patients with rectal neuroendocrine tumors within 20 mm following initial endoscopic resection: A multi-center study
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Le résumé fourni par la source
BACKGROUND: The incidence of rectal neuroendocrine tumors (RNETs) has witnessed a significant surge, with a notable proportion being amenable to endoscopic removal. However, the clinical significance of positive resection margin for RNETs patients following endoscopic resection remain unknown, resulting in a lack of consensus regarding the appropriateness of implementing salvage treatment. METHODS: In this large, multicenter, retrospective cohort study, we analyzed the medical records of individuals who underwent endoscopic resection for RNETs and classified them into two groups: the positive resection margin and the negative resection margin group. The overall survival (OS) and disease-free survival (DFS) were compared among two group. The independent variables were identified using univariate and multivariate logistic regression analyses to predict positive resection margin. Then, the model was established to predict the patients with positive resection margin using multivariate logistic regression. RESULTS: 181 RNETs patients (34.3 %) represented positive margin after endoscopic resection. Following a median follow-up period of 72 months, tumor recurrence manifested in 12 out of 527 patients (2.2 %) and the presence of positive resection margin was associated with worse DFS. Independent factors correlating with positive resection margin included endoscopic resection method choice, RNETs located in the low rectum, NLR >4.44 and tumor size exceeding 14.89 mm. A prediction model was therefore established with high predictive accuracy and excellent clinical applicability determined by calibration curves and DCA curve. Among RNETs patients with positive margin following endoscopic resection, implementing salvage treatment was beneficial for improving DFS and salvage endoscopic resection offer equal efficiency compared with salvage radical resection. CONCLUSIONS: Positive resection margin following endoscopic resection may indicate negative prognosis. Salvage treatment can improve the prognosis of RNETs patients with positive resection margin. Notably, salvage local resection exhibited similar efficacy compared with radical surgery in term of survival benefit.
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Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- Clinical significance of positive resection margin for patients with rectal neuroendocrine tumors within 20 mm following initial endoscopic resection: A multi-center study
- Date Crossref
- 01/11/2024
- Éditeur
- Elsevier BV
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
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Sun Yat-sen University Department of General Surgery (Colorectal Surgery) pays non établi dans la noticeUniversité ou école supérieure
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Sixth Affiliated Hospital of Sun Yat-sen University pays non établi dans la noticeÉtablissement de santé
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Wuxi Fourth People's Hospital pays non établi dans la noticeÉtablissement de santé
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Shenzhen Third People’s Hospital pays non établi dans la noticeÉtablissement de santé
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Shangqiu First People's Hospital pays non établi dans la noticeÉtablissement de santé
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First People’s Hospital of Zunyi pays non établi dans la noticeÉtablissement de santé
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Zhujiang Hospital pays non établi dans la noticeÉtablissement de santé
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The Fourth Affiliated Hospital of Dali University pays non établi dans la noticeUniversité ou école supérieure
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The Third People's Hospital of Shenzhen pays non établi dans la noticeStructure de recherche
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Shenqiu County People's Hospital pays non établi dans la noticeÉtablissement de santé
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Southern Medical University Zhujiang Hospital pays non établi dans la noticeUniversité ou école supérieure
Department of General Surgery (Colorectal Surgery) — Sun Yat-sen University, Sixth Affiliated Hospital of Sun Yat-sen University et Wuxi Fourth People's Hospital, avec 8 autres affiliations.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.