Two Different Endoscopic Treatments for Rectal Neuroendocrine Neoplasms

May 31, 2026 updated by: Dong Yang, Jilin University

Retrospective Comparative Study of Two Different Endoscopic Treatments for Rectal Neuroendocrine Neoplasms

The aim is to compare the safety and efficacy of endoscopic submucosal dissection (ESD) versus endoscopic partial muscle resection( EPMR) for the treatment of rectal neuroendocrine neoplasms (R-NENs), thereby providing guidance for optimizing therapeutic strategies. The investigators retrospectively analyzed consecutive patients with R-NENs who underwent endoscopic resection at our center between January 2020 and February 2026. Patients were assigned to either the ESD group or the EPMR group. Baseline characteristics and perioperative outcomes were compared, including the number of lesions, maximum lesion diameter, single-lesion procedure time, postoperative complications, positive margin rate, pathological staging, lymphovascular invasion, and the need for additional therapies.

Study Overview

Detailed Description

The investigators compared the safety and efficacy of endoscopic submucosal dissection (ESD) versus endoscopic partial muscle resection( EPMR) for the treatment of rectal neuroendocrine neoplasms (R-NENs), thereby providing guidance for optimizing therapeutic strategies. The investigators retrospectively analyzed consecutive patients with R-NENs who underwent endoscopic resection at our center between January 2020 and February 2026. Patients were assigned to either the ESD group or the EID group. Baseline characteristics and perioperative outcomes were compared, including the number of lesions, maximum lesion diameter, single-lesion procedure time, postoperative complications, positive margin rate, pathological staging, lymphovascular invasion, and the need for additional therapies. Through this comparative analysis, The investigators would identify the optimal endoscopic technique for treating rectal neuroendocrine tumors.

Study Type

Interventional

Enrollment (Estimated)

483

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Locations

      • Changchun, China, 130021
        • Active, not recruiting
        • The First Hospital of Jilin University
    • Jilin
      • Changchun, Jilin, China, 130021
        • Recruiting
        • The First Hospital of Jilin University
        • Contact:

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • Patients undergoing endoscopic treatment for rectal neuroendocrine neoplasms.
  • Lesion diameter less than 2 cm.
  • Preoperative auxiliary examinations indicating no peripheral lymph node or distant metastasis.
  • Endoscopic surgical approach limited to ESD or EPMR.

Exclusion Criteria:

  • Use of non-ESD or non-EPMR endoscopic techniques, such as ligation-assisted resection or Endoscopic Mucosal Resection (EMR).
  • Presence of other conditions deemed by the investigator to be unsuitable for participation in this study.
  • Patient or family refusal to participate.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Non-Randomized
  • Interventional Model: Parallel Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Active Comparator: ESD group
The ESD group would enroll cases undergoing endoscopic treatment for rectal neuroendocrine neoplasms, and the treatment method of all cases in this group should be endoscopic submucosal dissection (ESD).
ESD: A solution is injected beneath the mucosa to create a submucosal cushion, followed by the use of specialized electrosurgical knives to dissect directly within the submucosal layer, thereby achieving en bloc resection of the tumor.
Experimental: EID group
The EPMR group would enroll cases undergoing endoscopic treatment for rectal neuroendocrine neoplasms, and the treatment method of all cases in this group should be endoscopic partial muscle resection ( EPMR).
EID:Endoscopic Intermuscular Dissection (EID) is an ultra-minimally invasive technique derived from conventional Endoscopic Submucosal Dissection (ESD). Its core principle is not merely to dissect within the submucosal layer, but to "deepen" the dissection plane into the muscularis propria of the rectal wall. Specifically, the surgeon utilizes the natural anatomical plane between the inner circular muscle and the outer longitudinal muscle layers for precise dissection. This procedure involves resecting part of the affected inner circular muscle while preserving the integrity of the outer longitudinal muscle layer.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
the positive margin rate
Time Frame: One week after the endoscopic treatment
A positive margin indicates that cancer cells extend to the edge of the removed specimen, suggesting that residual tumor may remain in situ. The positive margin rate is calculated as the number of cases with positive margins divided by the total number of resected cases, expressed as a percentage. It serves as a critical quality indicator for the completeness of tumor removal.
One week after the endoscopic treatment

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Number of rectal neuroendocrine neoplasm lesions.
Time Frame: One week after the endoscopic treatment
The number of rectal neuroendocrine neoplasm lesions per case.
One week after the endoscopic treatment

Other Outcome Measures

Outcome Measure
Measure Description
Time Frame
Maximum lesion diameter.
Time Frame: one week after the endoscopic treatment
The longest diameter of each lesion was measured endoscopically and recorded in centimeters.
one week after the endoscopic treatment
Operation time per single lesion.
Time Frame: One week after the endoscopic dissection
The procedure time for each lesion was measured from the start of dissection to completion, expressed in minutes.
One week after the endoscopic dissection
Complications (including bleeding and perforation).
Time Frame: One week after the endoscopic dissection
All complications were recorded including bleeding and perforation.
One week after the endoscopic dissection

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

June 1, 2026

Primary Completion (Estimated)

November 1, 2026

Study Completion (Estimated)

December 1, 2027

Study Registration Dates

First Submitted

May 21, 2026

First Submitted That Met QC Criteria

May 21, 2026

First Posted (Actual)

May 29, 2026

Study Record Updates

Last Update Posted (Actual)

June 3, 2026

Last Update Submitted That Met QC Criteria

May 31, 2026

Last Verified

May 1, 2026

More Information

Terms related to this study

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

UNDECIDED

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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