Clinicopathological Characteristics of the primary and metastatic Hepatic Neuroendocrine Tumors and the relevant Prognosis-Related Factors: A Retrospective Study of 81 Cases in a Single Chinese Center

Abstract

Aims: We aim to describe the clinicopathological characteristics of hepatic neuroendocrine tumors (HNETs) and evaluate the relevant prognosis-related factors.Methods: The clinical data of 81 consecutive patients with primary or metastatic HNETs from March 2000 to July 2014 were retrospectively analyzed.Results: The mean (SD) age was 59.68 (11.64) years, 69.15% were men. The percentages of Grade G1, G2 and G3 tumors were 4.94%, 25.93% and 69.13%, respectively. Thirty-five cases were primary HNETs. Primary HNETs were more common in patients with larger tumors, lymph nodes invasions, tumor necrosis and portal vein tumor thrombus. The 1-, 3-, and 5-year overall survival rate were 88.89%, 32.10%, and 8.64%, separately. The relapse rate was 81.48% (66/81) and the mean (SD) relapse time was 18.79 (10.99) months. Reduced survival rate was associated with lymph node metastases (P=0.034), tumor necrosis (P=0.048), hard texture of tumor character (P=0.001), multifocality of tumor numbers (P=0.043), and the immunohistochemical expression of NSE (P=0.000) and Syn (P=0.037). Patients with metastatic HNETs were demonstrated with a more decreased period of Progression-free Survival (PFS) and Overall survival (OS) than their primary HNETs counterparts (P<0.05).Conclusion: Primary HNETs cohort patients were more common with aggressive clinical presentation. The hard texture of tumor character, multifocality of tumor numbers, and the immunohistochemical expression of NSE and Syn were independent predictive factors. Patients who were pathologically diagnosed as the primary HNETs seemed to achieve a long-term survival.

Clinical Features and Long-term Survivals of Metastatic Hepatic Neuroendocrine Neoplasms Secondary to Gastro-entero-pancreatic Site: An Analysis by Applying the World Health Organization 2017 Grading Classification

“…( Table 1). This demography was much close to the reports by some previous studies [26,27] . In our study, 64 MH-NENs were secondary to pancreas (42.7%), 96 cases were diagnosed synchronously with the primary lesions (64%), 127 cases showed over 50% estimated liver involvement (84.7%) and 42 cases simultaneously present extrahepatic invasion at diagnosis (28%).…”

“…Xiang et al reported in their research that 44.9% of MH-NENs originated from pancreas, 65.4% of cases present synchronous liver metastasis, 82.5% of cases had over 50% estimated liver involvement and 11.1% of cases present extrahepatic invasion [27] . As a result, our estimated 3-year OS for MH-NENs secondary to GEP-NENs was 45.6%, which was a little worse than that of previous studies [26,27] , probably due to the stricter inclusive criteria that MH-NENs in the present study was just secondary to gastroentero-pancreatic system, rather than other metastatic sites of NENs.…”

“…Considering the homogeneity of metastasis lessons and primary tumors, WHO grading classi cations originally proposed for GEP-NENs have also been introduced to MH-NENs secondary to GEP-NENs [13,14,22] . Using the WHO 2010 grading classi cation, Lv et al reported the percentage of G1, G2 and G3 among patients with H-NENs were respectively 4.94%, 25.93% and 69.13%, with a separate MST of 40.82mons, 51.87mons and 33.80mons [26] . There was signi cant difference on the OS when comparing G1/G2 NETs with "G3 NECs" (P = 0.011), while survival difference between G1 NETs and G2 NETs was not statistically signi cant (P > 0.05) [26] .…”

Treatment of primary hepatic neuroendocrine tumors with associating liver partition and portal vein ligation for staged hepatectomy (ALPPS)

“…[ 9 ] Tumors range in size from 0.4 to 19 cm (mean 6.84 ± 4.29 cm). [ 10 ] In our patient, the tumor measured 13 × 7 × 6 cm and involved the right 3 lobes of the liver. Routine histopathological examination using hematoxylin-eosin stains shows an insular, nested, trabecular or mixed cellular growth pattern, although this is a nonspecific finding.…”

“…Routine histopathological examination using hematoxylin-eosin stains shows an insular, nested, trabecular or mixed cellular growth pattern, although this is a nonspecific finding. [ 11 ] Lv et al [ 10 ] performed a retrospective study of the clinicopathological characteristics of 81 PHNETs and metastatic hepatic NETs and showed that patients with PHNETs demonstrated an aggressive clinical presentation. The hard texture of the tumor, multifocality of tumors, and the immunohistochemical expression of neuron-specific enolase and Syn were independent predictive factors.…”