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World J Gastroenterol. Mar 21, 2022; 28(11): 1123-1138
Published online Mar 21, 2022. doi: 10.3748/wjg.v28.i11.1123
Rectal neuroendocrine tumors: Current advances in management, treatment, and surveillance
Camilla Gallo, Roberta Elisa Rossi, Federica Cavalcoli, Federico Barbaro, Ivo Boškoski, Pietro Invernizzi, Sara Massironi
Camilla Gallo, Pietro Invernizzi, Sara Massironi, Division of Gastroenterology and Center for Autoimmune Liver Diseases, Department of Medicine and Surgery, University of Milano-Bicocca, European Reference Network on Hepatological Diseases, San Gerardo Hospital, Monza 20900, Italy
Roberta Elisa Rossi, Division of HPB Surgery, Hepatology and Liver Transplantation, Department of Pathophysiology and Transplantation, University of Milan, ENETS Center of Excellence, Fondazione IRCCS Istituto Nazionale Tumori (INT, National Cancer Institute), Milan 20133, Italy
Federica Cavalcoli, Diagnostic and Therapeutic Endoscopy Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milan 20133, Italy
Federico Barbaro, Ivo Boškoski, Digestive Endoscopy Unit, Università Cattolica del Sacro Cuore di Roma, Center for Endoscopic Research Therapeutics and Training, Fondazione Policlinico Universitario Agostino Gemelli IRCSS, Rome 00168, Italy
Author contributions: Massironi S, Gallo C, and Rossi RE conceived of the contents of the manuscript; Gallo C, Boskoski I, and Barbaro F developed the revision regarding the therapeutic options for r-NENs; Boskoski I and Barbaro F furnished the pictures; Massironi S developed the introduction, the surveillance paragraph, and the conclusive chapter; Rossi RE and Cavalcoli F developed the paragraph regarding the risk factors; Invernizzi P together with all authors, revised entirely the manuscript and contributed to its final aspect.
Conflict-of-interest statement: The authors declare no conflict of interests for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Sara Massironi, MD, PhD, Doctor, Division of Gastroenterology and Center for Autoimmune Liver Diseases, Department of Medicine and Surgery, University of Milano-Bicocca, European Reference Network on Hepatological Diseases, San Gerardo Hospital, Via Pergolesi, 33, Monza 20900, Italy. s.massironi@asst-monza.it
Received: October 15, 2021
Peer-review started: October 15, 2021
First decision: December 12, 2021
Revised: December 24, 2021
Accepted: February 20, 2022
Article in press: February 20, 2022
Published online: March 21, 2022
Processing time: 152 Days and 9 Hours
Core Tip

Core Tip: Rectal neuroendocrine neoplasms (r-NENs) represent 1%-2% of all rectal tumors, but an increasing incidence rate has been recently reported. Up to 90% of r-NENs are < 10 mm in size, confined to the submucosa, and well-differentiated, so that the endoscopic resection represents their gold-standard therapy. Advanced metastatic NENs are usually poorly differentiated G3 carcinomas treated with chemotherapy, except for rare G1-G2 neoplasms, which can be targeted with less aggressive systemic options. Locally advanced r-NENs invading submucosal layers, with a ≥ 10 mm diameter, but still without distant metastases, represent the real therapeutic challenge among rectal tumors.