• Beonghoon Sohn, Yoomin Kwon, Seung-Bum Ryoo, Inho Song, Yoon-Hye Kwon, Dong Woon Lee, Sang Hui Moon, Ji Won Park, Seung-Yong Jeong, and Kyu Joo Park.
• Department of Surgery, Seoul National University College of Medicine, 101 Daehak-ro (28 Yeongeon-dong), Jongno-Gu, Seoul, 03080, Korea.
• J. Gastrointest. Surg. 2017 Dec 1; 21 (12): 2066-2074.

IntroductionNeuroendocrine tumors have malignant potential, and lymph node metastasis can occur. This study aimed to identify predictive factors of lymph node metastasis and prognostic factors for survival in rectal neuroendocrine tumors.MethodsSixty-four patients underwent endoscopic or surgical treatment for rectal NET. The data on these patients were collected in our database prospectively and reviewed retrospectively.ResultsTransanal excision was performed in 28 (43.8%) patients, endoscopic mucosal resection or submucosal dissection was performed in 15 (23.4%) patients, and radical resection was performed in 21 (31.8%) patients. Lymph node and distant metastasis was present in 16 (25.0%) and fir (7.8%) patients. The significant risk factors for lymph node metastasis identified in the multivariable analyses were tumor size (≥ 2 cm, p = 0.003) and tumor grade (G2, p < 0.001; G3, p = 0.008). In patients with a tumor smaller than 2 cm, the risk factors for lymph node metastasis included the tumor grade, mitosis count, and Ki-67 index. The median follow-up period was 30.0 months, and recurrence developed in four (6.8%) patients. The significant prognostic factors for survival included tumor size, T stage, lymph node metastasis, and tumor grade.ConclusionTumor grade combined with tumor size is an important predictive factor for lymph node metastasis and could serve as a prognostic factor for survival outcomes.

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