Clinicopathologic characteristics and prognosis of gastroenteropancreatic neuroendocrine neoplasms: a multicenter study in South China

Cancer Communications

Jian Sun¹  Cheng Fang²  Wei Wang²  Zhiwei Zhou²  Ye Chen³  Minhu Chen⁴  Yu Zhang⁴  Jie Chen⁴  Yujie Zeng⁵  Xingyu Feng⁶  Yong Li⁶ 

[1] Department of Biliopancreatic Surgery, The Sun Yat-sen Memorial Hospital of Sun Yat-sen University, Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Guangzhou, P. R. China;Department of Gastric Surgery, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, P. R. China;Department of Gastroenterology, Nanfang Hospital of Southern Medical University, Guangdong Provincial Key Laboratory of Gastroenterology, Guangzhou, P. R. China;Department of Gastroenterology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, P. R. China;Department of Gastrointestinal Surgery, The Sun Yat-sen Memorial Hospital of Sun Yat-sen University, Guangzhou, P. R. China;Department of General Surgery, Guangdong General Hospital, Guangdong Academy of Medical Science, Guangzhou, P. R. China

关键词: Gastroenteropancreatic neuroendocrine neoplasms;    Surgery;    Prognosis;    China;   

DOI  :  10.1186/s40880-017-0218-3

学科分类：肿瘤学

来源: Springer

【 摘 要 】

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. 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. 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. 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.

【 授权许可】

CC BY