[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-0-en-105":3,"doc-seo-382440-105":59,"doc-detail-382440-en":130},{"code":4,"msg":5,"data":6},0,"success",[7,13,18,23,28,33,38,43,48,51,55],{"id":8,"doc_module":4,"doc_module_name":9,"category_name":10,"show_sort_weight":11,"slug":12},1,"Document","Story & Novel",90,"story-novel",{"id":14,"doc_module":4,"doc_module_name":9,"category_name":15,"show_sort_weight":16,"slug":17},2,"Literature",80,"literature",{"id":19,"doc_module":4,"doc_module_name":9,"category_name":20,"show_sort_weight":21,"slug":22},4,"Exam",70,"exam",{"id":24,"doc_module":4,"doc_module_name":9,"category_name":25,"show_sort_weight":26,"slug":27},5,"Comic",60,"comic",{"id":29,"doc_module":4,"doc_module_name":9,"category_name":30,"show_sort_weight":31,"slug":32},6,"Technology",50,"technology",{"id":34,"doc_module":4,"doc_module_name":9,"category_name":35,"show_sort_weight":36,"slug":37},7,"Healthcare",40,"healthcare",{"id":39,"doc_module":4,"doc_module_name":9,"category_name":40,"show_sort_weight":41,"slug":42},8,"Research & Report",30,"research-report",{"id":44,"doc_module":4,"doc_module_name":9,"category_name":45,"show_sort_weight":46,"slug":47},9,"Religion & Spirituality",20,"religion-spirituality",{"id":46,"doc_module":4,"doc_module_name":9,"category_name":49,"show_sort_weight":46,"slug":50},"World Cup","world-cup",{"id":52,"doc_module":4,"doc_module_name":9,"category_name":53,"show_sort_weight":52,"slug":54},10,"Lifestyle","lifestyle",{"id":56,"doc_module":4,"doc_module_name":9,"category_name":57,"show_sort_weight":24,"slug":58},19,"General","general",{"code":4,"msg":60,"data":61},"ok",{"site_id":62,"language":63,"slug":64,"title":65,"keywords":66,"description":67,"schema_data":68,"social_meta":123,"head_meta":125,"extra_data":127,"updated_unix":129},105,"en","optimising-outcomes-and-surveillance-strategies-of-rectal-neuroendocrine-neoplasms","Optimising Outcomes and Surveillance Strategies of Rectal Neuroendocrine Neoplasms","","Rectal neuroendocrine neoplasms show rising incidence, driven in part by expanded colonoscopy screening and incidental detection. Although many lesions are low-grade and well-differentiated, variable clinical behaviour and frequent mischaracterisation at endoscopy can lead to incomplete excision using standard polypectomy. The review outlines endoscopic and surgical options to improve the likelihood of an R0 resection, required staging procedures, and predictors of nodal involvement or recurrence. It also summarizes management of R1 resections and appropriate long-term surveillance strategies.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/optimising-outcomes-and-surveillance-strategies-of-rectal-neuroendocrine-neoplasms/382440/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/optimising-outcomes-and-surveillance-strategies-of-rectal-neuroendocrine-neoplasms/382440.png","ImageObject",300,407,{"name":92,"@type":93},"River Wang","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-29","2026-09-24",true,{"@type":102,"interactionType":103,"userInteractionCount":39},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"Why are rectal neuroendocrine neoplasms becoming more common?","Question",{"text":112,"@type":113},"Their incidence is increasing partly because more colonoscopic screening is being performed, leading to incidental findings of rectal NETs.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"What problem does mischaracterisation at endoscopy create?",{"text":117,"@type":113},"Lesions may be incorrectly characterised and then incompletely excised using standard polypectomy techniques.",{"name":119,"@type":110,"acceptedAnswer":120},"What determines surveillance and follow-up after resection?",{"text":121,"@type":113},"Post-resection management depends on staging and resection status, including higher-risk features, long-term surveillance needs, and when to offer surveillance to patients, especially after R1 resection.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},382440,1790305373,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":39,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":139,"language":140,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":67,"update_tm":144,"read_time":145},1099514067438,"https://ap-avatar.wpscdn.com/avatar/100002539ee87300030?x-image-process=image/resize,m_fixed,w_180,h_180&k=1780474512215547542","cancers   \nReview  \nOptimising Outcomes and Surveillance Strategies of Rectal Neuroendocrine Neoplasms  \nRajaventhan Srirajaskanthan 1,2,*, Dominique Clement 1,2, Sarah Brown 1,2, Mark R. Howard 3 and John K. Ramage 1,4  \nCitation: Srirajaskanthan, R.; Clement, D.; Brown, S.; Howard, M.R.; Ramage, J.K. Optimising Outcomes and Surveillance Strategies of Rectal Neuroendocrine Neoplasms. Cancers 2023, 15, 2766. [https://doi.org/](https://doi.org/)[ ](https://doi.org/)[10.3390/cancers15102766](10.3390/cancers15102766)  \nAcademic Editor: Fortunato Ciardiello  \nReceived: 21 February 2023  \nRevised: 5 April 2023  \nAccepted: 5 May 2023  \nPublished: 15 May 2023  \nCopyright: © 2023 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ([https://](https://)[ ](https://)[creativecommons.org/licenses/by/](creativecommons.org/licenses/by/)[ ](creativecommons.org/licenses/by/)[4.0/](4.0/)) .  \n1 Kings Health Partners, ENETS Centre of Excellence, Institute of Liver Studies, King's College Hospital, London SE5 9RS, UK  \n2 Department of Gastroenterology, King's College Hospital, London SE5 9RS, UK  \n3 Department of Histopathology, Kings Health Partners, ENETS Centre of Excellence, King's College Hospital, London SE5 9RS, UK  \n4 Department of Gastroenterology, Hampshire Hospitals NHS Foundation Trust, Basingstoke RG24 9NA, Hampshire, UK  \n* Correspondence: [r.srirajaskanthan@nhs.net](r.srirajaskanthan@nhs.net); Tel.: +44-203-299-6034  \nSimple Summary: Rectal neuroendocrine neoplasms are increasing in incidence due in part to increased use of colonoscopy for colon cancer screening. These lesions can be difficult to characterise by endoscopists and, therefore, may be removed using an inappropriate endoscopic technique. Rectal neuroendocrine tumours should be fully staged prior to resection and this will help determine the best endoscopic approach for removal. Post resection, some of these tumours require ongoing surveillance. This article provides a detailed review of current evidence available to optimise assessment and removal of these lesions and approaches to surveillance for patients with rectal neuroendocrine tumours.  \nAbstract: Rectal neuroendocrine neoplasms are increasing in incidence, in part due to increased endoscopic procedures being performed for bowel cancer screening. Whilst most of these lesions are low-grade well-differentiated neuroendocrine tumours, they can have a varied clinical behaviour. Frequently, these lesions are incorrectly characterised at endoscopy and, therefore, incompletely excised using standard polypectomy techniques. Furthermore, some cases are not fully staged prior to or post resection. In this article we discuss the endoscopic and surgical options available to improve the likelihood of achieving an R0 resection and the staging procedures that should be used in these NETs. We also review factors that may suggest a higher risk of nodal involvement or recurrence. This information may help determine whether endoscopic or surgical resection techniques should be considered. In cases of R1 resection we discuss the management options available and the long-term surveillance options and when these should be offered to patients.  \nKeywords: rectal neuroendocrine tumors; MRI; endoscopy; surveillance; grade; staging  \n1. Introduction  \nRectal neuroendocrine neoplasms (NENs) have an increasing incidence due in part to the increased colonoscopic screening being undertaken to reduce the incidence of colorectal cancer [1,2] . Many countries have established screening programmes suggesting routine colonoscopy from the age of 45 or triaging patients for colonoscopy using stool tests such as the faecal immunochemical test (FIT) [3], which have resulted in several patients being identified with rectal NETs as incidental findings. The data from Public Health England (PHE) and the Surveillance, Epidemio","cbCaihkBNhsvzYYI","https://ap.wps.com/l/cbCaihkBNhsvzYYI","pdf",19640562,11,"English","# Introduction\n## Rising incidence and screening context\n## Clinical classification and malignant potential\n## Rationale for staging and multidisciplinary management\n# Endoscopic assessment and resection approach\n## Optimising outcomes and adverse features\n## Management of incomplete resections (R1/R2)","[{\"question\":\"Why are rectal neuroendocrine neoplasms becoming more common?\",\"answer\":\"Their incidence is increasing partly because more colonoscopic screening is being performed, leading to incidental findings of rectal NETs.\"},{\"question\":\"What problem does mischaracterisation at endoscopy create?\",\"answer\":\"Lesions may be incorrectly characterised and then incompletely excised using standard polypectomy techniques.\"},{\"question\":\"What determines surveillance and follow-up after resection?\",\"answer\":\"Post-resection management depends on staging and resection status, including higher-risk features, long-term surveillance needs, and when to offer surveillance to patients, especially after R1 resection.\"}]","Optimising Outcomes and Surveillance Strategies of Rectal Neuroendocrine Neoplasms | PDF",1790250426,28]