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Assessment of the Risk of Nodal Involvement in Rectal Neuroendocrine Neoplasms: The NOVARA Score, a Multicentre Retrospective Study

Rectal neuroendocrine tumors (r-NETs) are rare tumors with overall good prognosis after complete resection. However, there is no consensus on the extension of lymphadenectomy or regarding contraindications to extensive resection. In this study, we aim to identify predictive factors that correlate wi...

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Autores principales: Ricci, Angela Dalia, Pusceddu, Sara, Panzuto, Francesco, Gelsomino, Fabio, Massironi, Sara, De Angelis, Claudio Giovanni, Modica, Roberta, Ricco, Gianluca, Torchio, Martina, Rinzivillo, Maria, Prinzi, Natalie, Rizzi, Felice, Lamberti, Giuseppe, Campana, Davide
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8836953/
https://www.ncbi.nlm.nih.gov/pubmed/35160165
http://dx.doi.org/10.3390/jcm11030713
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author Ricci, Angela Dalia
Pusceddu, Sara
Panzuto, Francesco
Gelsomino, Fabio
Massironi, Sara
De Angelis, Claudio Giovanni
Modica, Roberta
Ricco, Gianluca
Torchio, Martina
Rinzivillo, Maria
Prinzi, Natalie
Rizzi, Felice
Lamberti, Giuseppe
Campana, Davide
author_facet Ricci, Angela Dalia
Pusceddu, Sara
Panzuto, Francesco
Gelsomino, Fabio
Massironi, Sara
De Angelis, Claudio Giovanni
Modica, Roberta
Ricco, Gianluca
Torchio, Martina
Rinzivillo, Maria
Prinzi, Natalie
Rizzi, Felice
Lamberti, Giuseppe
Campana, Davide
author_sort Ricci, Angela Dalia
collection PubMed
description Rectal neuroendocrine tumors (r-NETs) are rare tumors with overall good prognosis after complete resection. However, there is no consensus on the extension of lymphadenectomy or regarding contraindications to extensive resection. In this study, we aim to identify predictive factors that correlate with nodal metastasis in patients affected by G1–G2 r-NETs. A retrospective analysis of G1–G2 r-NETs patients from eight tertiary Italian centers was performed. From January 1990 to January 2020, 210 patients were considered and 199 were included in the analysis. The data for nodal status were available for 159 cases. The nodal involvement rate was 9%. A receiver operating characteristic (ROC) curve analysis was performed to identify the diameter (>11.5 mm) and Ki-67 (3.5%), respectively, as cutoff values to predict nodal involvement. In a multivariate analysis, diameter > 11.5 mm and vascular infiltration were independently correlated with nodal involvement. A risk scoring system was constructed using these two predictive factors. Tumor size and vascular invasion are predictors of nodal involvement. In addition, tumor size > 11.5 mm is used as a driving parameter of better-tailored treatment during pre-operative assessment. Data from prospective studies are needed to validate these results and to guide decision-making in r-NETs patients in clinical practice.
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spelling pubmed-88369532022-02-12 Assessment of the Risk of Nodal Involvement in Rectal Neuroendocrine Neoplasms: The NOVARA Score, a Multicentre Retrospective Study Ricci, Angela Dalia Pusceddu, Sara Panzuto, Francesco Gelsomino, Fabio Massironi, Sara De Angelis, Claudio Giovanni Modica, Roberta Ricco, Gianluca Torchio, Martina Rinzivillo, Maria Prinzi, Natalie Rizzi, Felice Lamberti, Giuseppe Campana, Davide J Clin Med Article Rectal neuroendocrine tumors (r-NETs) are rare tumors with overall good prognosis after complete resection. However, there is no consensus on the extension of lymphadenectomy or regarding contraindications to extensive resection. In this study, we aim to identify predictive factors that correlate with nodal metastasis in patients affected by G1–G2 r-NETs. A retrospective analysis of G1–G2 r-NETs patients from eight tertiary Italian centers was performed. From January 1990 to January 2020, 210 patients were considered and 199 were included in the analysis. The data for nodal status were available for 159 cases. The nodal involvement rate was 9%. A receiver operating characteristic (ROC) curve analysis was performed to identify the diameter (>11.5 mm) and Ki-67 (3.5%), respectively, as cutoff values to predict nodal involvement. In a multivariate analysis, diameter > 11.5 mm and vascular infiltration were independently correlated with nodal involvement. A risk scoring system was constructed using these two predictive factors. Tumor size and vascular invasion are predictors of nodal involvement. In addition, tumor size > 11.5 mm is used as a driving parameter of better-tailored treatment during pre-operative assessment. Data from prospective studies are needed to validate these results and to guide decision-making in r-NETs patients in clinical practice. MDPI 2022-01-28 /pmc/articles/PMC8836953/ /pubmed/35160165 http://dx.doi.org/10.3390/jcm11030713 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Ricci, Angela Dalia
Pusceddu, Sara
Panzuto, Francesco
Gelsomino, Fabio
Massironi, Sara
De Angelis, Claudio Giovanni
Modica, Roberta
Ricco, Gianluca
Torchio, Martina
Rinzivillo, Maria
Prinzi, Natalie
Rizzi, Felice
Lamberti, Giuseppe
Campana, Davide
Assessment of the Risk of Nodal Involvement in Rectal Neuroendocrine Neoplasms: The NOVARA Score, a Multicentre Retrospective Study
title Assessment of the Risk of Nodal Involvement in Rectal Neuroendocrine Neoplasms: The NOVARA Score, a Multicentre Retrospective Study
title_full Assessment of the Risk of Nodal Involvement in Rectal Neuroendocrine Neoplasms: The NOVARA Score, a Multicentre Retrospective Study
title_fullStr Assessment of the Risk of Nodal Involvement in Rectal Neuroendocrine Neoplasms: The NOVARA Score, a Multicentre Retrospective Study
title_full_unstemmed Assessment of the Risk of Nodal Involvement in Rectal Neuroendocrine Neoplasms: The NOVARA Score, a Multicentre Retrospective Study
title_short Assessment of the Risk of Nodal Involvement in Rectal Neuroendocrine Neoplasms: The NOVARA Score, a Multicentre Retrospective Study
title_sort assessment of the risk of nodal involvement in rectal neuroendocrine neoplasms: the novara score, a multicentre retrospective study
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8836953/
https://www.ncbi.nlm.nih.gov/pubmed/35160165
http://dx.doi.org/10.3390/jcm11030713
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