The Clinicopathological Characteristic S Of Patients With Rectal Or Pulmonary Neuroendocrine Tumor

Objective:To study the characteristic of rectal and pulmonary neuroendocrine tumor; Identify important prognostic factors and evaluate the therapeutic methodsMethod:From January2004to December2009,57pathologically diagnosed rectal neuroendocrine tumor and46pulmonary neuroendocrine tumor were collected from Cancer hospital and institution of Chinese academy of medical science. The characteristic features and prognostic factors were evaluated retrospectively.Results:For rectal neuroendocrine tumor, the male:female rate is1.57:1.Median age is54years old.49cases were typical carcinoid,3cases were atypical carcinoid and5cases were poorly differentiated neuroendocrine carcinoma or small cell carcinoma. Tumor size was no larger than1cm in27cases,1-2cm in15cases and no less than2cm in6cases. Accoding to the invasion extent,T stage was presented in the following percentage: T188.1%, T22.4%T32.4%and T47.1%.There were9cases with lymph node involvement and4cases with metastastic lesion.Totally54patients underwent surgery including40transanal wide excision,2endoscopic therapy,9DIXON surgery and3MILES surgery.3patients received palliative radiotherapy or chemotherapy. Five years survival rate is88.6%. Univariate analysis showed that age,tumor size,pathology type,T stage,lymph node involvement, metastastic lesion,TNM stage were correlated with overall survival.A statistical Mutivariate Cox regression analysis showed that pathology type is the independent prognostic factor (p=0.004).For pulmonary neuroendocrine tumor, the male:female rate is2.07:1.Median age is56years old.31cases were typical carcinoid,15cases were atypical carcinoid tumor size was no larger than3cm in19cases,3-7cm in19cases and no less than7cm in15cases.There were12cases with lymph node involvement and1cases with metastastic lesion.Totally45patients underwent surgery including2wedge resection,5sleeved resection,29lobectomy,2bilobectomy,7pneumonectomy. Concurrent chemoradiotherapy was received by1case.5years survival rate is81.1%. Univariate analysis showed that age and pathology type were correlated with overall survival. Mutivariate analysis showed that pathology type is independent prognostic factor (p=0.027).Conclusion:Neuroendocrine tumors arising from rectum or lung have distinctive clinicopathological factors as well as excellent prognosis.However,different pathology subtypes influenced survival significantly. Tumor in early stage could receive surgery and the effect is satisfactory. But prognosis became poor after metastasis even patients received radiotherapy or chemotherapy.