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

Xie, Jian‐Wei; Lü, Jun; Wang, Jia-Bin; Ji, Lin; Chen, Qi‐Yue; Cao, Long‐Long; Ma, Lin; Tu, Ru‐Hong; Huang, Ze-Ning; Lin, Ju‐Li; Zheng, Chao‐Hui; Li, Ping; Huang, Chang‐Ming

doi:10.1186/s12885-018-4943-z

Cited by 36 publications

(39 citation statements)

References 21 publications

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“…The outcomes of GNENs varied significantly between gastric NEC (GNEC) and gastric NET (GNET). And the prognosis of GNEC remained unsatisfying, which was significantly poorer than that of gastric adenocarcinomas (GAC) [4,5]. Compared with other gastrointestinal NENs, patients with GNENs also presented with much lower Ping Hu, Jian'an Bai and Min Liu have contributed equally to this work.…”

Section: Introductionmentioning

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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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: Introductionmentioning

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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“…For patients with gNET, somatostain was recommended. For patients with stage II or higher gNEC or gMANEC, uorine-based postoperative adjuvant chemotherapy was recommended [18]. The study was approved by the Ethics Committees of FMUUH and FMUFAH.…”

Section: Patient Selectionmentioning

confidence: 99%

“…For Ki-67, 60% positive was considered the cut-off point. The ASA physical status classi cation system was used in this research [18,23]. ASA I, patient is healthy with no systemic disease; ASA II, patient has mild systemic disease; ASA III, patient has severe systemic disease or multiple diseases affecting different organ systems; ASA IV, patient has severe systemic disease that is a constant threat to life; ASA V, patient is moribund and not expected to survive without the operation; and ASA VI, brain dead patient whose organs are being removed for donation [24,25].…”

Section: Variables and De Nitionsmentioning

confidence: 99%

Effects of sarcopenia on short- and long-term outcomes in patients with gastric neuroendocrine neoplasms after radical gastrectomy: Results from a large, two-institution series

Wang

Zhang

Lü

et al. 2020

Preprint

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Background: The relationship between sarcopenia and prognoses of patients with gastric neuroendocrine neoplasms (g-NENs) is unclear. This study was designed to explore the effects of sarcopenia on short-term and long-term outcomes of patients with g-NENs after radical gastrectomy. Methods: This study retrospectively collected data of 138 patients with g-NENs after radical gastrectomy. The skeletal muscle index (SMI) diagnostic threshold for sarcopenia was determined using X-tile software. Cox regression were used to determine the independent risk factors for 3-year overall survival (OS) and 3-year recurrence-free survival (RFS). Results: In this study, there were 59 patients (42.8%) with sarcopenia. Among the sarcopenia group and nonsarcopenia group, the incidences of total postoperative complications were 33.9% and 30.4%, of serious postoperative complications 0% and 3.7%, of postoperative surgical complications 13.6% and 15.2%, of postoperative systemic complications 20.3% and 15.2% (all p>0.05). The 3-year OS and RFS rates were significantly worse in the sarcopenia group than in the nonsarcopenia group (OS:42.37% vs 65.82%, p=0.004; RFS:52.54% vs 68.35%, p=0.036). Multivariate analysis showed that sarcopenia was related to long-term prognoses of g-NENs patients. A stratified analysis based on pathological type revealed that the Kaplan-Meier curve was only significantly different in patients with gastric mixed adenoneuroendocrine carcinoma (gMANEC) (OS: 40.00% vs 71.79%, p=0.007; RFS: 51.43% vs 74.36%, p=0.026); furthermore, multivariate analysis showed that sarcopenia was an independent risk factor for gMANEC patients (p<0.05).Conclusion: Sarcopenia is not related to short-term prognoses of g-NENs patients. Sarcopenia is an independent risk factor for patients with gMANEC after radical surgery.

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“…Kim et al [12] found that G-NEC has shorter progression-free survival (PFS) than gastric adenocarcinoma. Huang et al [13] found that the prognosis of patients with more than 50% of neuroendocrine cancer components is signi cantly poorer than that of patients with less than 50% components. All of these studies provide evidence that tumors containing neuroendocrine cancer components may contribute to a worse prognosis.…”

Section: Introductionmentioning

confidence: 99%

Comparison of overall survival of gastric neoplasms containing neuroendocrine carcinoma components with gastric adenocarcinoma: a propensity score matching study

Chen

Wang

et al. 2020

Preprint

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BackgroundGastric neoplasms containing neuroendocrine carcinoma (NEC) components are rare malignancies with highly aggressive behavior and a poor prognosis and include pure NEC and mixed tumors containing NEC components. We aimed to investigate whether there is a distinct difference in overall survival (OS) between gastric neoplasms containing NEC components and gastric adenocarcinoma.MethodsSurgically resected gastric neoplasms containing NEC components (n=180) and gastric adenocarcinomas (n=785) from January 2013 to December 2019 at Peking University Cancer Hospital were retrospectively analysed. Patients were categorized into a surgical group and a neoadjuvant group and adjusted using propensity score matching. In the two groups, gastric neoplasms containing NEC components were divided into pure NEC and mixed tumors with less than 30% (<30% G-HMiNEN), between 30% and 70% (G-HMiNEN) and more than 70% (>70% G-HMiNEN) neuroendocrine carcinoma components. OS was compared between these groups and the gastric adenocarcinoma group.ResultsThe OS of gastric neoplasms containing neuroendocrine NEC components was poorer than that of gastric adenocarcinomas in the surgical group, regardless of whether the percentage of neuroendocrine cancer components was less than 30%, between 30% and 70%, more than 70% or 100%. Cox multivariable regression analysis suggested that tumor category (neoplasms containing NEC components or gastric adenocarcinoma) was an independent risk factor for prognosis. Interestingly, among patients receiving neoadjuvant therapy, the difference was not significant.ConclusionsGastric neoplasms containing any proportion of NEC components had poorer overall survival than gastric adenocarcinoma in patients treated with surgery directly, indicating a higher degree of malignancy than gastric adenocarcinoma. Among the patients receiving neoadjuvant therapy, the difference in overall survival was not significant, which was in sharp contrast with the results of the surgery group, suggesting that neoadjuvant therapy may have a good effect in the treatment of these neoplasms.

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

Cited by 36 publications

References 21 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

Effects of sarcopenia on short- and long-term outcomes in patients with gastric neuroendocrine neoplasms after radical gastrectomy: Results from a large, two-institution series

Comparison of overall survival of gastric neoplasms containing neuroendocrine carcinoma components with gastric adenocarcinoma: a propensity score matching study

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