ArticleTechniques in coloproctology2024
When is neoadjuvant chemotherapy indicated in rectal neuroendocrine tumors? An analysis of the National Cancer Database.
Article in Techniques in coloproctology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed.
- [Rectal neuroendocrine tumors of the rectum: update on endoscopic and surgical treatment].Chirurgie (Heidelberg, Germany) · 2026Review
- Rectal Neuroendocrine Tumours: A 10-Year Review of Clinical Presentation, Pathological Features, and Treatment Outcomes from a Tertiary Care Cancer Centre in Western India.Indian journal of surgical oncology · 2026Article
- Rectal neuroendocrine tumors: Update.World journal of gastrointestinal oncology · 2026Review
- Impact of Neoadjuvant Chemotherapy on Perioperative Tumor Marker Dynamics and Postoperative Recovery in Patients Undergoing Laparoscopic Radical Resection for Rectal Cancer.Journal of gastrointestinal cancer · 2025Article
- Endoscopic therapy versus surgical resection for elderly patients with colorectal neuroendocrine tumors.Surgical endoscopy · 2024Article
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Authors and funding
6 authors.
Funding
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Abstract
backgroundRectal neuroendocrine tumors (rNET) are rare and challenging to manage. While most patients with small rNET can be definitively treated with local excision, the role of chemotherapy in general and neoadjuvant therapy particularly in managing advanced rNET has not been well established. Therefore, this study aimed to determine which patients with rNET may gain a survival benefit from neoadjuvant chemotherapy.
methodsA retrospective cohort analysis of all patients who underwent surgical resection of rNET in the US National Cancer Database (NCDB) (2004-2019) was performed. First, univariate and multivariate Cox regression analyses were performed to determine the independent predictors of poor overall survival (OS) and define the high-risk groups. Afterward, stratified OS analyses were performed for each high-risk group to assess whether neoadjuvant chemotherapy had a survival benefit in each group.
resultsA total of 1837 patients (49.8% female; mean age 56.6 ± 12.3 years) underwent radical resection of a rNET. Tumors > 20 mm in size, clinical T4 tumors, poorly differentiated tumors, and metastatic disease were independent predictors of worse OS and were defined as high-risk groups. Neoadjuvant chemotherapy did not have a significant survival benefit in any of the high-risk groups, except for patients with high-grade rNETs where neoadjuvant therapy significantly improved OS to a mean of 30.9 months compared with 15.9 months when neoadjuvant therapy was not given (p = 0.006).
conclusionsNeoadjuvant chemotherapy improved the OS of patients with high-grade rNET by 15 months and may be indicated for this group.
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