Evaluation of clinicopathological factors related to the prognosis of gastric neuroendocrine carcinoma

Xie, Jian‐Wei; Sun, Yanwu; Feng, Changyin; Zheng, Chao‐Hui; Li, P.; Wang, J.-B.; Ji, Lin; Lü, Jun; Chen, Q.-Y.; Cao, Long‐Long; Ma, Lin; Tu, Ru‐Hong; Yang, Yinghong; Huang, Chang‐Ming

doi:10.1016/j.ejso.2016.08.004

Cited by 32 publications

(26 citation statements)

References 16 publications

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“…Effective risk stratification instruments are needed to make clinical guides. The most widely used AJCC staging has been questioned in prognosis prediction of GNEC patients [8]. Moreover, additional clinicopathological characteristics including age, Ki-67 index and therapeutic options have also been proven to be important predictors of GNENs [20][21][22].…”

Section: Discussionmentioning

confidence: 99%

“…TNM staging proposed by American Joint Committee on Cancer (AJCC) is now one of the most important prognostic factors for gastroenteropancreatic NENs (GEP-NENs). Previous reports indicated that AJCC staging played an important role in predicting the survival rates of GEP-NENs [8,9]. However, many other factors, such as age, treatment or grade, which were not involved in AJCC staging system might affect the outcomes of GEP-NENs as well [10][11][12].…”

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confidence: 99%

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Trends of incidence and prognosis of gastric neuroendocrine neoplasms: a study based on SEER and our multicenter research

Bai

Liu

et al. 2020

Gastric Cancer

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Background To investigate the recent epidemiological trends of gastric neuroendocrine neoplasms (GNENs) and establish a new tool to estimate the prognosis of gastric neuroendocrine carcinoma (GNEC) and gastric neuroendocrine tumor (GNET). Methods Nomograms were established based on a retrospective study on patients diagnosed with GNENs from 1975 to 2016 in Surveillance, Epidemiology and End Results database. External validation was performed among 246 GNENs patients in Jiangsu province to verify the discrimination and calibration of the nomograms. Results The age-adjusted incidence of GNENs has increased from 0.309 to 6.149 per 1,000,000 persons in the past 4 decades. Multivariate analysis indicated independent prognostic factors for both GNEC and GNET including age, distant metastasis and surgical intervention (P < 0.05). In addition, T, N staging and grade were significantly associated with survival of GNEC, while size was a predictor for GNET (P < 0.05). The C-indexes of the nomograms were 0.840 for GNEC and 0.718 for GNET, which were higher than those of the 8th AJCC staging system (0.773 and 0.599). Excellent discrimination was observed in the validation cohorts (C-index of nomogram vs AJCC staging for GNEC: 0.743 vs 0.714; GNET: 0.945 vs 0.927). Survival rates predicted by nomograms were close to the actual survival rates in the calibration plots in both training and validation sets. Conclusions The incidence of the GNENs is increasing steadily in the past 40 years. We established more excellent nomograms to predict the prognosis of GNENs than traditional staging system, helping clinicians to make tailored decisions.

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

Trends of incidence and prognosis of gastric neuroendocrine neoplasms: a study based on SEER and our multicenter research

Bai

Liu

et al. 2020

Gastric Cancer

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“…Accurate prognostic prediction is crucial for patients with gMANEC who undergo radical surgery. However, the ability of TNM staging to predict prognosis in those with NEC remains controversial [ 20 , 21 ]. To our knowledge, whether TNM staging accurately predicts gMANEC prognosis has not been reported.…”

Section: Discussionmentioning

confidence: 99%

Prognostic factors for survival after curative resection of gastric mixed adenoneuroendocrine carcinoma: a series of 80 patients

et al. 2018

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BackgroundTo assess the prognostic factors and investigate the optimal treatment of gastric mixed adenoneuroendocrine tumors.MethodsWe retrospectively analyzed clinical data from 80 patients with gastric mixed adenoneuroendocrine carcinoma that received radical resection in our department from January 2007 to December 2016. Risk factors for relapse and survival were analyzed using a multivariate Cox proportional hazards regression model. Gastric mixed adenoneuroendocrine carcinoma was divided into neuroendocrine carcinoma and adenocarcinoma based on the predominant type in the tumor.ResultsThe 3-year overall survival was 40% in the neuroendocrine carcinoma group and 75% in the adenocarcinoma group (P = 0.006). The neuroendocrine carcinoma (NEC)-dominant tumors and a Ki-67-positive index ≥60% were independent risk factors for worse overall survival. The 3-year recurrence-free survival was 33% in the neuroendocrine carcinoma group and 68% in the adenocarcinoma group. NEC-dominant tumors and a Ki-67-positive index ≥60% were independent risk factors for gastric mixed adenoneuroendocrine carcinoma recurrence. Patients in the adenocarcinoma group that received adjuvant chemotherapy exhibited significantly better overall survival than patients that did not receive chemotherapy (median survival time 43 months vs. 13 months, P = 0.026).ConclusionThe NEC-dominant tumors and a Ki-67-positive index ≥60% were significantly associated with worse survival and a higher recurrence rate for gastric mixed adenoneuroendocrine carcinoma patients. Patients in the adenocarcinoma group may benefit from gastric adenocarcinoma treatments.Electronic supplementary materialThe online version of this article (10.1186/s12885-018-4943-z) contains supplementary material, which is available to authorized users.

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“…There is expert consensus that surgery alone is rarely curative and that patients with limited disease should probably receive multimodality based treatment. Surgery as part of the treatment can be curative in patients with localized disease even with regional lymph node disease; however, the data often does not distinguish between NET G3 and NEC [8,9,[40][41][42][43][44]. The 5-year survival for localized disease depends on the primary site; for colorectal, stomach, and pancreas primaries the 5-year survival is 40-50%, but it is less for anal (15%) and esophageal (25%) primaries [14].…”

Section: Surgerymentioning

confidence: 99%

Unmet Needs in High-Grade Gastroenteropancreatic Neuroendocrine Neoplasms (WHO G3)

et al. 2018

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Gastroenteropancreatic (GEP) neuroendocrine neoplasms (NEN) are classified based on morphology and graded based on their proliferation rate as either well-differentiated low-grade (G1 to G2) neuroendocrine tumors (NET) or poorly differentiated high-grade (G3) neuroendocrine carcinomas (NEC). Recently, a new subgroup of well-differentiated high-grade pancreatic tumors (NET G3) has been defined. The GEP NEN G3 group consisting of both NEC and NET G3 has recently been shown to be a quite heterogeneous patient group concerning prognosis and treatment benefit, depending on factors such as the primary tumor site, differentiation, proliferation rate, and molecular alterations. In this review we discuss the existing data on diagnostics, treatment, and biomarkers in this patient group, the unmet needs, and the future perspectives.

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Evaluation of clinicopathological factors related to the prognosis of gastric neuroendocrine carcinoma

Cited by 32 publications

References 16 publications

Trends of incidence and prognosis of gastric neuroendocrine neoplasms: a study based on SEER and our multicenter research

Trends of incidence and prognosis of gastric neuroendocrine neoplasms: a study based on SEER and our multicenter research

Prognostic factors for survival after curative resection of gastric mixed adenoneuroendocrine carcinoma: a series of 80 patients

Unmet Needs in High-Grade Gastroenteropancreatic Neuroendocrine Neoplasms (WHO G3)

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