P-253 - EUS before endoscopic management of small Rectal NETs is not essential process

Date 04 July 2015
Event WorldGI 2015
Session Posters
Topics Neuroendocrine Cancers
Imaging, Diagnosis and Staging
Presenter W.C. Kim
Citation Annals of Oncology (2015) 26 (suppl_4): 1-100. 10.1093/annonc/mdv233
Authors W.C. Kim, Y.Y. Choi, D.H. Kang, H.W. Kim, C.W. Choi, S.B. Park, S.J. Kim, D.I. Jeong
  • Pusan National University Yangsan Hospital, Yangsan/KR



The size and depth of invasion of tumors is the most significant factors in the endoscopic management of rectal neuroendocrine tumors (NETs). Endoscopic treatment is usually used to cure for lesions ≤10 mm that do not include the muscularis propria. We retrospectively investigated the utility of endoscopic ultrasonography (EUS) for decision of endoscopic treatment in rectal NETs ≤10 mm.


Patients who diagnosed rectal NETs by endoscopic resection in the Pusan National University Yangsan Hospital from 2009 to 2013 were enrolled in this study. The rectal lesions were resected using endoscopic resection, such as endoscopic mucosal resection (EMR), endoscopic submucosal dissection, EMR with precut, cap and band ligation, and were diagnosed with NETs by histologic confirm. With using a known size reference such as an open biopsy forceps, size by EUS, and by histology, we compared size by endoscopy.


A total of 124 small rectal NETs (less than 10 mm) in 120 patients were enrolled in this study. Size by endoscopy and size by EUS correlated with histological size (r = 0.732 [p < 0.001] and r = 0.756 [p < 0.001]). Size by endoscopy strongly correlated with size by EUS (r = 0.952 [p < 0.001]). Size by endoscopy was not significantly different from size by EUS and histology ([p = 0.172] and [p = 0.261]). Accuracy of involvement depth in the EUS was 91.5%. There was no muscularis propria involvement in the rectal NETs ≤10 mm.


Although the size and depth by EUS was relatively exact, there was a significant correlation between the size by endoscopy, EUS, and histology in the small rectal NETs. The size by endoscopy was not significantly different from the size by EUS and histology. Moreover, there was no muscularis propria invasion in the small rectal NETs. Therefore, we suggest that EUS before endoscopic treatment of the small rectal NETs is not essential process.