The Clinicopathological Features and Overall Survival of Patients With Gastric Neuroendocrine Carcinoma

Xu, Bin; Chu, Yuxin; Hu, Qinyong; Song, Qibin

doi:10.1177/15330338211055340

Cited by 6 publications

(5 citation statements)

References 24 publications

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“…Besides, recent studies indicated that poorly differential NENs had a good response to the chemotherapy, which might explain the better OS of patients with NENs [ 19 , 20 ]. Moreover, recent studies have reported that gastric NEC has unique clinicopathological features quite different from intestinal-type gastric cancer (IGC) and may have a superior survival to IGC in early-stage patients, indicating that NENs have better survival than other pathological types of cancers, like adenocarcinoma [ 21 , 22 ], which is consistent with our research.…”

Section: Discussionsupporting

confidence: 92%

The clinical and prognostic factors for biliary neuroendocrine neoplasm: a study based on the SEER database

et al. 2022

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Background In this study, we aimed at elucidating the postoperative survival and prognostic factors in patients with biliary neuroendocrine neoplasm (NEN). Methods Cases of biliary system NEN and adenocarcinoma from 1975 to 2016 were extracted from the Surveillance, Epidemiology, and End Results (SEER) database. A propensity score matching (PSM) method was used to adjust baseline differences in clinicopathological characteristics in our analysis. The Kaplan–Meier analysis was carried out for survival analysis. Results A total of 233 patients with biliary system NEN were enrolled in this study, of which 119 patients’ lesions located in gallbladder, while the others’ located in bile duct. The postoperative overall survival of bile duct NEN is significantly longer than that of gallbladder NEN (P < 0.001). For gallbladder NENs, surgery method (P = 0.020) and lymph node metastasis (P = 0.018) were identified as independent prognostic factors. In terms of ampulla of vater (AOV) NENs, age (P = 0.017) and lymph node metastasis (P = 0.006) were identified as independent prognostic factors, while grade (P = 0.002) and lymph node metastasis (P = 0.036) were identified as independent prognostic factors for extrahepatic bile duct (EBD) NENs. PSM analysis indicated that patients with biliary duct NENs have a better postoperative prognosis than biliary duct adenocarcinoma. Conclusions Patients with NEN have better overall survival than patients with adenocarcinoma. Gallbladder NEN has an adverse prognosis than that of biliary tract NEN. The pathological subtype, differentiation, lymph node metastasis, surgery method, and lymph node resection could affect the postoperative prognosis of the gallbladder and biliary tract NEN.

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Section: Discussionsupporting

confidence: 92%

The clinical and prognostic factors for biliary neuroendocrine neoplasm: a study based on the SEER database

et al. 2022

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“…Then the subgroup analyses and multivariate competing risks regression analysis confirmed no significant relationship between chemotherapy and CSD. Patients in the chemotherapy cohort presented higher proportion of male, grade III/IV, primary site of cardia, and tumor size over 5 cm, which had been confirmed as high-risk factors in previous studies [ 18 ]. Therefore, a lower percentage of high-risk variables in the no-chemotherapy cohorts and other probable comorbidities not recorded in the SEER database might help partially explain the difference in OCD between the two groups.…”

Section: Discussionsupporting

confidence: 66%

“…Xu et al conducted a comparative study between intestinal-type GC (IGC) and GNEC patients, demonstrating that GNEC patients presented a longer survival to ICG in the early-stage tumor. And age, gender, tumor size, AJCC stage, T stage, N stage, and surgery were considered the risk factors with the OS of GNEC patients [ 18 ]. As in our study, the multivariate competing risk analysis found older age, male gender, greater tumor diameter, and higher TNM stage as independent risk factors for CSD.…”

Section: Discussionmentioning

confidence: 99%

De-escalating chemotherapy for stage I–II gastric neuroendocrine carcinoma? A real-world competing risk analysis

Xie

et al. 2023

World J Surg Onc

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Background The role of adjuvant chemotherapy in gastric neuroendocrine neoplasms (GNEC) has not been well clarified yet. The study was designed to investigate the potential effect of adjuvant chemotherapy in stage I–II GNEC patients and construct a predictive nomogram. Method Stage I–II GNEC patients were included in the Surveillance, Epidemiology, and End Results (SEER) database and divided into chemotherapy and no-chemotherapy groups. We used Kaplan–Meier survival analyses, propensity score matching (PSM), and competing risk analyses. The predictive nomogram was then built and validated. Results Four hundred four patients with stage I–II GNEC were enrolled from the SEER database while 28 patients from Hangzhou TCM Hospital were identified as the external validation cohort. After PSM, similar 5-year cancer-specific survival was observed in two groups. The outcomes of competing risk analysis indicated a similar 5-year cumulative incidence of cancer-specific death (CSD) between the two cohorts (35.4% vs. 31.4%, p = 0.731). And there was no significant relation between chemotherapy and CSD in the multivariate competing risks regression analysis (HR, 0.79; 95% CI, 0.48–1.31; p = 0.36). Furthermore, based on the variables from the multivariate analysis, a competing event nomogram was created to assess the 1-, 3-, and 5-year risks of CSD. The 1-, 3-, and 5-year area under the receiver operating characteristic curve (AUC) values were 0.770, 0.759, and 0.671 in the training cohort, 0.809, 0.782, and 0.735 in the internal validation cohort, 0.786, 0.856, and 0.770 in the external validation cohort. Furthermore, calibration curves revealed that the expected and actual probabilities of CSD were relatively consistent. Conclusion Stage I–II GNEC patients could not benefit from adjuvant chemotherapy after surgery. De-escalation of chemotherapy should be considered for stage I–II GNEC patients. The proposed nomogram exhibited excellent prediction ability.

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“…Dasari et al [ 21 ] found that in distant gastrointestinal neuroendocrine neoplasms, Asians or Pacific Islanders were identified as an independent risk factor associated with poor prognosis compared with Whites. However, a recent study [ 23 ] did not recognize race as an independent risk factor related to prognosis in patients with GNEC. In this study, with 653 GNEC patients, there were just three categories of the race including Whites, Blacks, and others, which did not split up Asians separately as a race.…”

Section: Discussionmentioning

confidence: 99%

Better Prognosis of Gastric Neuroendocrine Carcinoma Than Gastric Adenocarcinoma among Whites in the United States: A Propensity Score Matching Analysis Based on SEER

Ren

Zhao

et al. 2022

Current Oncology

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It was generally believed that the prognosis of gastric neuroendocrine carcinoma (GNEC) was worse than gastric adenocarcinoma (GAC). However, almost all previous studies compared the prognosis of GNEC and GAC based on East Asians. In this study, we evaluated the clinicopathological features and prognosis of GNEC and GAC in Whites. Patients with GNEC and GAC were identified from 2000 to 2018 in the Surveillance, Epidemiology, and End Results (SEER) database. We used propensity score matching (PSM) analysis to match the age, sex, TNM stage, and treatments received between GNEC and GAC, then compared the overall survival (OS) and cancer-specific survival (CSS) in the two types. A total of 392 cases of GNEC and 12,835 cases of GAC in Whites were recognized. After PSM, the 5-year OS rates of GNEC and GAC were 50.3% and 43.0%, respectively (p = 0.010). The 5-year CSS rates of GNEC and GAC were 57.4% and 50.1%, respectively (p = 0.012). Besides, multivariable cox regression analyses showed that GNEC was an independent predictor of improved OS (HR 0.719; 95% CI 0.607–0.853) and CSS (HR 0.691; 95% CI 0.571–0.835) in the matched data. The prognosis of GNEC was better than GAC in Whites, showing significant ethnic differences. Appropriate treatments and follow-up strategies for GNEC in Whites are probably different from East Asians. The potential genetic and molecular mechanisms need to be further explored.

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The Clinicopathological Features and Overall Survival of Patients With Gastric Neuroendocrine Carcinoma

Cited by 6 publications

References 24 publications

The clinical and prognostic factors for biliary neuroendocrine neoplasm: a study based on the SEER database

The clinical and prognostic factors for biliary neuroendocrine neoplasm: a study based on the SEER database

De-escalating chemotherapy for stage I–II gastric neuroendocrine carcinoma? A real-world competing risk analysis

Better Prognosis of Gastric Neuroendocrine Carcinoma Than Gastric Adenocarcinoma among Whites in the United States: A Propensity Score Matching Analysis Based on SEER

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