Comparison of endoscopic submucosal dissection and modified endoscopic mucosal resection for rectal neuroendocrine tumors

Abstract Although some studies have compared the treatment outcomes between modified endoscopic mucosal resection (m-EMR) and endoscopic submucosal dissection (ESD) for rectal neuroendocrine tumors (NETs), the results are based on the experience of experts from a single high-volume center. This mult...

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Main Authors: Yoshiyasu Kitagawa, Takuto Suzuki, Akihiro Miyakawa, Kenichiro Okimoto, Tomoaki Matsumura, Toshiyasu Shiratori, Hideaki Ishigami, Takeshi Mine, Hideyuki Takashiro, Hirofumi Saito, Naoya Kato
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Language:English
Published: Nature Portfolio 2025-02-01
Series:Scientific Reports
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Online Access:https://doi.org/10.1038/s41598-024-82082-7
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author Yoshiyasu Kitagawa
Takuto Suzuki
Akihiro Miyakawa
Kenichiro Okimoto
Tomoaki Matsumura
Toshiyasu Shiratori
Hideaki Ishigami
Takeshi Mine
Hideyuki Takashiro
Hirofumi Saito
Naoya Kato
author_facet Yoshiyasu Kitagawa
Takuto Suzuki
Akihiro Miyakawa
Kenichiro Okimoto
Tomoaki Matsumura
Toshiyasu Shiratori
Hideaki Ishigami
Takeshi Mine
Hideyuki Takashiro
Hirofumi Saito
Naoya Kato
author_sort Yoshiyasu Kitagawa
collection DOAJ
description Abstract Although some studies have compared the treatment outcomes between modified endoscopic mucosal resection (m-EMR) and endoscopic submucosal dissection (ESD) for rectal neuroendocrine tumors (NETs), the results are based on the experience of experts from a single high-volume center. This multicenter study aimed to compare the outcomes between m-EMR and ESD for rectal NETs, with emphasis on the operator’s level. Data of patients with rectal NETs treated using m-EMR or ESD at seven institutions that included general hospitals in Japan were retrospectively reviewed. Patients treated using m-EMR and those treated using ESD were matched for age, sex, lesion size, lesion location, and operator level through propensity score matching. The treatment outcomes were compared between the two groups. In total 304 patients (m-EMR = 178, ESD = 126) were included, with 218 in the matched groups (m-EMR = 109, ESD = 109). The R0 resection rate was not significantly different between the two groups (90.0% vs. 82.3%, P = .221). However, the procedural time was significantly shorter for the m-EMR group than that for the ESD group (6 vs. 26 min, P < .001). No significant difference in adverse events was observed between the two groups (postprocedure bleeding rate: 5.5% vs. 2.8%, P = .335; perforation rate: 0.9% vs. 0.9%, P = 1.00). Subgroup analysis revealed that the R0 resection rate for the trainees was significantly higher in the m-EMR group than in the ESD group (87.9% vs. 64.5%, P = .017). m-EMR is the preferred technique for the treatment of rectal NETs and should be considered, particularly for the trainees.
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spelling doaj-art-713e6fe9daf14bc9b6f614e528d6fa4a2025-08-20T03:00:58ZengNature PortfolioScientific Reports2045-23222025-02-011511810.1038/s41598-024-82082-7Comparison of endoscopic submucosal dissection and modified endoscopic mucosal resection for rectal neuroendocrine tumorsYoshiyasu Kitagawa0Takuto Suzuki1Akihiro Miyakawa2Kenichiro Okimoto3Tomoaki Matsumura4Toshiyasu Shiratori5Hideaki Ishigami6Takeshi Mine7Hideyuki Takashiro8Hirofumi Saito9Naoya Kato10Endoscopy Division, Chiba Cancer CenterEndoscopy Division, Chiba Cancer CenterDepartment of Gastroenterology, Asahi General HospitalDepartment of Gastroenterology, Chiba UniversityDepartment of Gastroenterology, Chiba UniversityDepartment of Gastroenterology, Kameda Medical CenterDepartment of Gastroenterology, Chiba Rosai HospitalDepartment of Gastroenterology, Kimitsu Chuo HospitalDepartment of Gastroenterology, Chiba Kaihin Municipal HospitalDepartment of Gastroenterology, Chiba Kaihin Municipal HospitalDepartment of Gastroenterology, Chiba UniversityAbstract Although some studies have compared the treatment outcomes between modified endoscopic mucosal resection (m-EMR) and endoscopic submucosal dissection (ESD) for rectal neuroendocrine tumors (NETs), the results are based on the experience of experts from a single high-volume center. This multicenter study aimed to compare the outcomes between m-EMR and ESD for rectal NETs, with emphasis on the operator’s level. Data of patients with rectal NETs treated using m-EMR or ESD at seven institutions that included general hospitals in Japan were retrospectively reviewed. Patients treated using m-EMR and those treated using ESD were matched for age, sex, lesion size, lesion location, and operator level through propensity score matching. The treatment outcomes were compared between the two groups. In total 304 patients (m-EMR = 178, ESD = 126) were included, with 218 in the matched groups (m-EMR = 109, ESD = 109). The R0 resection rate was not significantly different between the two groups (90.0% vs. 82.3%, P = .221). However, the procedural time was significantly shorter for the m-EMR group than that for the ESD group (6 vs. 26 min, P < .001). No significant difference in adverse events was observed between the two groups (postprocedure bleeding rate: 5.5% vs. 2.8%, P = .335; perforation rate: 0.9% vs. 0.9%, P = 1.00). Subgroup analysis revealed that the R0 resection rate for the trainees was significantly higher in the m-EMR group than in the ESD group (87.9% vs. 64.5%, P = .017). m-EMR is the preferred technique for the treatment of rectal NETs and should be considered, particularly for the trainees.https://doi.org/10.1038/s41598-024-82082-7Rectal neuroendocrine tumorEndoscopic submucosal dissectionModified endoscopic mucosal resection
spellingShingle Yoshiyasu Kitagawa
Takuto Suzuki
Akihiro Miyakawa
Kenichiro Okimoto
Tomoaki Matsumura
Toshiyasu Shiratori
Hideaki Ishigami
Takeshi Mine
Hideyuki Takashiro
Hirofumi Saito
Naoya Kato
Comparison of endoscopic submucosal dissection and modified endoscopic mucosal resection for rectal neuroendocrine tumors
Scientific Reports
Rectal neuroendocrine tumor
Endoscopic submucosal dissection
Modified endoscopic mucosal resection
title Comparison of endoscopic submucosal dissection and modified endoscopic mucosal resection for rectal neuroendocrine tumors
title_full Comparison of endoscopic submucosal dissection and modified endoscopic mucosal resection for rectal neuroendocrine tumors
title_fullStr Comparison of endoscopic submucosal dissection and modified endoscopic mucosal resection for rectal neuroendocrine tumors
title_full_unstemmed Comparison of endoscopic submucosal dissection and modified endoscopic mucosal resection for rectal neuroendocrine tumors
title_short Comparison of endoscopic submucosal dissection and modified endoscopic mucosal resection for rectal neuroendocrine tumors
title_sort comparison of endoscopic submucosal dissection and modified endoscopic mucosal resection for rectal neuroendocrine tumors
topic Rectal neuroendocrine tumor
Endoscopic submucosal dissection
Modified endoscopic mucosal resection
url https://doi.org/10.1038/s41598-024-82082-7
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