Factors associated with lymph node metastasis in radically resected rectal carcinoids: a systematic review and meta-analysis.

BACKGROUND

Although various guidelines regarding neuroendocrine tumors were released, treatment for rectal neuroendocrine tumors with size between 1 and 2 cm has not been explicitly elucidated. The determinant factor of the choice between endoscopic resection and radical surgery is whether lymph node involvement exists.

AIM: This study aims to explore factors associated with lymph node involvement in rectal neuroendocrine tumors by conducting a meta-analysis.

METHODS

A broad literature research of Pubmed, Embase&Medline, and The Cochrane Library was performed, and systematic review and meta-analysis about factors associated with lymph node involvement were conducted.

RESULTS

Seven studies were included in this meta-analysis. Tumor size > 1 cm (odds ratio (OR) 6.72, 95% confidence interval (CI) [3.23, 14.02]), depth of invasion (OR 5.06, 95% CI [2.30, 11.10]), venous invasion (OR 5.92, 95% CI [2.21, 15.87]), and central depression (OR 3.00, 95% CI [1.07, 8.43]) were significantly associated with lymph node involvement.

CONCLUSION

The available clinical evidence suggests that tumor size > 1 cm, invasion of muscularis properia, venous invasion, and central depression could be risk factors of lymph node involvement, while other factors reported by few studies need further research.