Clinicopathological characteristics and outcomes of rectal neuroendocrine tumors according to resection modality

This study aimed to compare the effects of different treatment methods on the postoperative results and long-term prognosis of patients with 1-2 cm rectal neuroendocrine tumors (R-NETs), and provide evidence-based guidance for the treatment decision-making of this specific tumor size. The retrospective cohort study of this single-center included 736 patients with pathologically diagnosed R-NETs who were treated from January 2013 to August 2024. According to the treatment received, the patients were divided into endoscopic resection group (ER), local surgery group (LS) and radical surgery group (RS). The primary endpoint was recurrence free survival (RFS). A total of 736 R-NETs patients were enrolled. For the controversial 1–2 cm tumor, there was no significant difference in the long-term RFS between the LS group and the ER group ( P = 0.280), and the postoperative hospitalization days of the LS group was relatively short (median 2 days vs. 3 days, P < 0.001). Sensitivity analysis using propensity score matching (PSM) further confirmed these outcomes in postoperative hospitalization days ( P < 0.001). For 1–2 cm R-NETs, recurrence events were rare in both treatment groups, and local surgery was associated with a shorter postoperative hospital stay.