Survival Comparison Between Primary Hepatic And Pancreatic Neuroendocrine Neoplasms And The Analysis On Prognosis-related Factors

Objectives:Primary hepatic neuroendocrine neoplasms(PHNENs)are extremely rare and few literatures had compared the prognosis of PHNENs with other NENs.This study was designed to investigate the different prognosis of PHNENs and pancreatic neuroendocrine tumors(PanNENs)and to analysis of prognosis-related factors.Methods:The clinical date of 12 PHNENs patients and 67 PanNENs patients were collected from the First Affiliated Hospital of Zhejiang University School of Medicine from January 2012 to January 2017.Demographic,clinical characteristics and survival data were compared between the two groups with Kaplan-Meier method and log-rank tests.Prognostic factors were analyzed using the Cox regression model.Results:The mean overall survival of Group PHNENs and Group PanNENs were 27.1±25.1 months and 46.2±20.5 months,respectively(P=0.026).The cumulative survival of Group PanNENs was significant higher than Group PHNENs(P=0.002).Univariate analysis revealed that symptom,hemoglobin,albumin,total bilirubin,total bile acid,alanine aminotransferase,aspartate aminotransferase,alkaline phosphatase,a-fetoprotein,carbohydrate antigen 19-9,histological types,treatments and primary tumor site were the risk factors of survival.To these factors,further multivariate analysis indicated that histological types(P=0.004),treatments(P<0.001)and albumin(P=0.006)were the risk factors which can influence the survival.Based on the histological types,the cumulative survival of patients with neuroendocrine tumors was significant higher than patients with neuroendocrine carcinomas both in Group PHNENs(P=0.022)and in Group PanNENs(P=0.003).According to the different treatments,patients who received surgery showed significant higher cumulative survival than the rest both in Group PHNENs(P=0.003)and Group PanNENs(P<0.001).According to serum albumin:≤35 g/L,the cumulative survival of patients with normal level of albumin was significantly higher than patients with lower serum albumin in Group PHNENs(P=0.005),but the difference was not significant in Group PanNENs(P=20.072).Conclusion:PHNENs have lower survival rate compared to PanNENs.Histological types and treatments are independent risk factors for long-term survival of patients with PHNENs and PanNENs.Serum albumin levels are closely related to prognosis.For PHNENs and PanNENs,surgical resection is still the first choice if the lesions can be resected which can significantly improve the survival.