Open AccessClinicopathologic characteristics and prognosis of gastroenteropancreatic neuroendocrine neoplasms: a multicenter study in South China
Author(s) -
Fang Cheng,
Wang Wei,
Zhang Yu,
Feng Xingyu,
Sun Jian,
Zeng Yujie,
Chen Ye,
Li Yong,
Chen Minhu,
Zhou Zhiwei,
Chen Jie
Publication year - 2017
Publication title -
cancer communications
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.119
H-Index - 53
ISSN - 2523-3548
DOI - 10.1186/s40880-017-0218-3
Subject(s) - medicine , rectum , gastroenterology , neuroendocrine tumors , proportional hazards model , stage (stratigraphy) , cohort , survival analysis , pancreas , oncology , paleontology , biology
Background Gastroenteropancreatic neuroendocrine neoplasms (GEP‐NENs) are a heterogeneous group of rare tumors. Many issues in terms of epidemiologic features, pathogenesis, and treatment of GEP‐NENs are still under discussion. Our study aimed to analyze the clinicopathologic characteristics and prognosis of Chinese patients with GEP‐NENs. Methods Complete clinicopathologic data and survival information of 1183 patients with GEP‐NENs treated between 2005 and 2015 were collected from five medical centers in Guangdong Province, China. Patient survival was estimated using the Kaplan–Meier method and analyzed using the log‐rank test; prognostic factors were analyzed using the Cox proportional hazards model. Results The most common tumor location was the rectum (37.4%), followed by the pancreas (28.1%), stomach (20.7%), small intestine (7.2%), appendix (3.4%), and colon (3.3%). After initial definitive diagnosis, 1016 (85.9%) patients underwent surgery. The 1‐, 3‐, and 5‐year overall survival (OS) rates for the entire cohort were 87.9%, 78.5%, and 72.8%, respectively. The 3‐year OS rates of patients with G1, G2, and G3 tumors were 93.1%, 82.7%, and 43.1%, respectively ( P < 0.001). The 3‐year OS rates of patients with stage I, II, III, and IV tumors were 96.0%, 87.3%, 64.0%, and 46.8%, respectively ( P < 0.001). Patients with distant metastasis who underwent palliative surgery had a longer survival than those who did not ( P = 0.003). Similar survival benefits of palliative surgery were observed in patients with neuroendocrine tumor ( P = 0.031) or neuroendocrine carcinoma ( P = 0.046). In multivariate analysis, age, grade, N category, M category, and surgery were found to be independent prognostic factors. Conclusions Patients with GEP‐NENs who are women, younger than 50 years old, have smaller tumor size, have lower tumor grade, have lower T/N/M category, and who undergo surgery can have potentially longer survival time. Our data showed that surgery can improve the prognosis of GEP‐NEN patients with distant metastasis. However, randomized controlled trials need to be conducted to establish the optimal criteria for selecting patients to undergo surgery.