{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T01:29:27Z","timestamp":1777426167014,"version":"3.51.4"},"reference-count":33,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2025,6,10]],"date-time":"2025-06-10T00:00:00Z","timestamp":1749513600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Digestive Endoscopy"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>This study aimed to identify risk factors for recurrence of rectal neuroendocrine neoplasms, establish a cut\u2010off size for recurrence prediction, and standardize surveillance guidelines.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This retrospective study analyzed patients diagnosed with rectal neuroendocrine neoplasm at Samsung Medical Center from January 2007 to July 2021. Tumors were classified according to World Health Organization and European Neuroendocrine Tumor Society guidelines. The primary outcome was to determine the ideal cut\u2010off size for predicting recurrence.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 1011 patients (median follow\u2010up: 58\u2009months) were included: 967 with grade (G) I neuroendocrine tumor (NET), 35 with GII NET, and 9 with neuroendocrine carcinoma. Disease\u2010free and overall survival were significantly better in GI NET than in GII and neuroendocrine carcinoma. For NET G1 patients undergoing endoscopic resection, a 0.7\u2009cm cut\u2010off (area under the curve\u2009=\u20090.94) showed 100% sensitivity, 79% specificity, and no recurrence. In contrast, for lymphovascular invasion (LVI)\u2010positive, lymph node\u2013negative NET G1 patients undergoing transanal endoscopic microsurgery\/transanal excision or radical resection, an optimal cut\u2010off of 1.5\u2009cm (area under the curve\u2009=\u20090.92) was identified. NET G2 had a 22.9% lymph node metastasis rate, with recurrence risk increasing with size.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>For NET G1 tumors \u22640.7\u2009cm without LVI following endoscopic resection, routine surveillance may not be necessary due to the minimal risk of recurrence. Similarly, for LVI\u2010positive, lymph node\u2013negative NET G1 tumors that underwent surgical resection, surveillance may not be required if the tumor is \u22641.5\u2009cm. Additionally, NET G2 tumors require regular follow\u2010up regardless of size to ensure favorable oncologic outcomes. These findings contribute to a risk\u2010based approach for surveillance, optimizing follow\u2010up strategies.<\/jats:p><\/jats:sec>","DOI":"10.1111\/den.15056","type":"journal-article","created":{"date-parts":[[2025,6,10]],"date-time":"2025-06-10T21:48:58Z","timestamp":1749592138000},"page":"962-971","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Size matters: Establishing a cut\u2010off for rectal neuroendocrine neoplasm to predict recurrence and standardize surveillance guidelines"],"prefix":"10.1111","volume":"37","author":[{"given":"Seijong","family":"Kim","sequence":"first","affiliation":[{"name":"Department of Surgery, Samsung Medical Center Sungkyunkwan University School of Medicine  Seoul Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eun Ran","family":"Kim","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Department of Internal Medicine, Samsung Medical Center Sungkyunkwan University School of Medicine  Seoul Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sung Noh","family":"Hong","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Department of Internal Medicine, Samsung Medical Center Sungkyunkwan University School of Medicine  Seoul Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dong Kyung","family":"Chang","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Department of Internal Medicine, Samsung Medical Center Sungkyunkwan University School of Medicine  Seoul Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Young\u2010Ho","family":"Kim","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Department of Internal Medicine, Samsung Medical Center Sungkyunkwan University School of Medicine  Seoul Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jung 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Hyeon","family":"Yun","sequence":"additional","affiliation":[{"name":"Department of Surgery, Samsung Medical Center Sungkyunkwan University School of Medicine  Seoul Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Woo Yong","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Surgery, Samsung Medical Center Sungkyunkwan University School of Medicine  Seoul Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yong Beom","family":"Cho","sequence":"additional","affiliation":[{"name":"Department of Surgery, Samsung Medical Center Sungkyunkwan University School of Medicine  Seoul Korea"},{"name":"Department of Health Sciences and Technology SAIHST, Sungkyunkwan University  Seoul Korea"},{"name":"Department of Biopharmaceutical Convergence Sungkyunkwan University  Seoul 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