Neuroendocrine neoplasm of the gallbladder: Clinical features, surgical efficacy, and prognosis

Abstract

Background Neuroendocrine neoplasm (NEN) of the gallbladder is rare. It is usually asymptomatic and occurs in older adults. Its clinicopathological characteristics remain controversial, and the diagnosis and treatment strategies are usually based on models of adenocarcinoma. The present study aimed to investigate the clinical characteristics and prognosis of gallbladder NEN. Methods The data of patients with gallbladder NEN admitted to Peking Union Medical College Hospital was reviewed, and a database was established for retrospective analysis. Clinicopathological features were analyzed descriptively and the prognosis was studied according to different factors. The Kaplan–Meier curve was used to describe the cumulative survival rate. Results In total, 22 patients with gallbladder NEN were included in this study. There were 10 male (45.5%) and 12 female (54.5%) patients with a median age of onset of NEN at 57.5 (49.0, 62.3) years. Abdominal discomfort was the most common symptom. Twenty patients (90.9%) underwent surgery, and two patients (9.1%) with unresectable lesions underwent a biopsy. Twenty‐one patients were followed up. The 1‐, 2‐, and 3‐year cumulative overall survival rates of all patients and patients with resectable lesions were 65.9%, 54.9%, and 48.1%, and 72.9%, 60.7%, and 53.1%, respectively. Patients with resectable lesions had a better cumulative overall survival rate than those who with unresectable lesions (p < 0.001). Conclusion Gallbladder NEN is more common in the elderly and has a slight female predominance. The most common symptom is abdominal discomfort. Surgery is the first choice of treatment for this rare disease. The prognosis of gallbladder NEN is generally poor. Patients with resectable lesions have a better prognosis.

Neuroendocrine neoplasms of the gallbladder: A single institute analysis of outcomes and prognostic factors

“…NENs of the GB are rare tumors. They tend to occur in older individuals with higher female predisposition as seen in the present study with 70.7% of patients being females 4 . Among NENs, NEC is the most common type occurring in the GB with 84.4% of the present population being NECs followed by MiNEN in 12.9%.…”

“…In their population, up to 50.2% of patients were node negative which is unlike in our population where 76.2% had nodal spread at presentation. Xin Wu et al reported their experience with 20 patients who underwent surgery, where median survival was 15 months, and emphasized the role of surgery to improve survival 4 …”

“…Patients who are not suitable for surgery, either due to locally advanced or metastatic nature of disease should be started on systemic chemotherapy. Since NEC and MiNEN are highly aggressive tumors with a high tendency for nodal metastasis, it is prudent to offer them adjuvant chemotherapy after surgical resection 4,15 …”

“…As per the latest classification system by the World Health Organization (WHO), NENs are classified as neuroendocrine carcinomas (NECs), mixed neuroendocrine and nonneuroendocrine neoplasms (MiNENs), and neuroendocrine tumors (NETs), according to tumor composition, degree of differentiation and grade 3 . Gallbladder (GB) NENs are very rare, accounting for 2% of all gallbladder neoplasms and 0.5% of all NENs 4 . NEN of the GB is commonly seen in elderly females and NEC is the most common type of NEN encountered 4 .…”

“…Gallbladder (GB) NENs are very rare, accounting for 2% of all gallbladder neoplasms and 0.5% of all NENs 4 . NEN of the GB is commonly seen in elderly females and NEC is the most common type of NEN encountered 4 . Clinical presentation is similar to that of adenocarcinoma of the GB but with a worse prognosis 2,5,6 .…”