Rectal neuroendocrine tumors: Current advances in management, treatment, and surveillance

Camilla Gallo, Pietro Invernizzi, Sara Massironi, Roberta Elisa Rossi, Federica Cavalcoli, Federico Barbaro, Ivo Boskoski

Research output: Contribution to journalReview articlepeer-review


Rectal neuroendocrine neoplasms (r-NENs) are considered among the most frequent digestive NENs, together with small bowel NENs. Their incidence has increased over the past few years, and this is probably due to the widespread use of endoscopic screening for colorectal cancer and the advanced endoscopic procedures available nowadays. According to the current European Neuroendocrine Tumor Society (ENETS) guidelines, well-differentiated r-NENs smaller than 10 mm should be endoscopically removed in view of their low risk of local and distant invasion. R-NENs larger than 20 mm are candidates for surgical resection because of their high risk of distant spreading and the involvement of the muscularis propria. There is an area of uncertainty regarding tumors between 10 and 20 mm, in which the metastatic risk is intermediate and the endoscopic treatment can be challenging. Once removed, the indications for surveillance are scarce and poorly codified by international guidelines, therefore in this paper, a possible algorithm is proposed.

Original languageEnglish
Pages (from-to)1123-1138
Number of pages16
JournalWorld Journal of Gastroenterology
Issue number11
Publication statusPublished - Mar 21 2022


  • Endoscopic submucosal dissection
  • Endoscopy
  • Rectal neuroendocrine tumors
  • Resectable advanced disease
  • Systemic therapy

ASJC Scopus subject areas

  • Gastroenterology


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