Open AccessClinicopathological features and prognosis of patients with gastric neuroendocrine tumors: A population‐based study
Author(s) -
Tian FangXi,
Cai YuQing,
Zhuang LvPing,
Chen MingFang,
Xiu ZhongBiao,
Zhang Yi,
Liu Hong,
Liu ZhiHong,
Liu GuoPing,
Zeng Chen,
Lin FeiLing,
Liu Jing,
Huang SiTing,
Zhang LiangZhi,
Lin HuaYang
Publication year - 2018
Publication title -
cancer medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.403
H-Index - 53
ISSN - 2045-7634
DOI - 10.1002/cam4.1683
Subject(s) - medicine , stage (stratigraphy) , neuroendocrine tumors , multivariate analysis , epidemiology , incidence (geometry) , proportional hazards model , gastroenterology , population , multivariate statistics , retrospective cohort study , disease , oncology , biology , paleontology , statistics , physics , mathematics , environmental health , optics
Background Despite its rarity, studies have shown the incidence of gastric neuroendocrine tumors (G‐ NET s) is increasing. This study investigated the risk factors affecting the survival of G‐ NET s patients and their prognosis over time. Method A retrospective analysis of 506 G‐ NET s patients who underwent surgery for nonmetastatic disease from the Surveillance, Epidemiology and End Result database from 1988 to 2011 was conducted. Multivariate Cox regression analyses identified the prognostic factors affecting overall survival ( OS ) and disease‐specific survival ( DSS ). Three‐year conditional survival ( COS 3 and CDS 3) estimates at “ x ” year after treatment were calculated as follows: COS 3 = OS ( x + 3)/ OS ( x ) and CDS 3 = DSS ( x + 3)/ DSS ( x ). Results The 1‐, 3‐, and 5‐year OS rates of all patients after surgery were 90.2%, 77.3%, and 68.8%, respectively. The 1‐, 3‐, and 5‐year DSS rates after surgery were 93.9%, 84.5%, and 80.9%, respectively. In the multivariate analysis, age, tumor grade, and T stage were independent prognostic factors of OS and DSS (all P < 0.05). With 1‐, 3‐, and 5‐year survivorship, the COS 3 improved by +5.2 (82.2%), +7.2 (84.4%), and +8.5 (85.5%), respectively, and the CDS 3 improved by +4.4 (89.4%), +9.1 (94.1%), and +12.5 (97.5%), respectively. Notably, the CDS 3 improved dramatically among patients with advanced stage disease (eg, N0 stage: 93.0%‐98.9%, Δ5.9% vs N1 stage: 52.0%‐95.7%, Δ43.7%). Conclusion For G‐ NET s patients, age, tumor grade, T stage, and N stage were the clinicopathological factors significantly associated with prognosis. There were excellent outcomes for most G‐ NET s patients, with a CDS 3 of greater than 90% across all independent prognostic factors after 5 years of survival.