Clinical Features And Prognosis Of One Hundred And Fifty Two Patients With Gastroenteropancreatic Neuroendocrine Neoplasms:Retrospective Single-centre Study

Purpose: The prognosis and behavior of gastroenteropancreatic neuroendocrine neoplasms(GEP-NENs)vary and may be divergent even within the same stage or tumor grade.We performed a retrospective study in our center to analyze clinical features,prognosis,and clinical application of NET G3 grading in GEP-NENs.Methods: We conducted a retrospective analysis of 148 cases of GEP-NENs treated by surgery or endoscopy at the First Affiliated Hospital of Fujian Medical University from July 2007 to July 2017.Survival analysis was performed using the Kaplan-Meier method to analyze risk factors affecting the prognosis of GEP-NENs.Statistical analysis was performed using SPSS version 21.0(IBM Corporation,Armonk,NY,USA).Results: Of the 148 patients,85 were male(57.4%),and 63 were female(42.6%).The primary sites oftumor in 47 cases(31.8%)were of the stomach,10(6.8%)were of the duodenum,5(3.4%)were of the ampulla,5(3.4%)were of the colon,40(27.0%)were of the rectum,7(4.7%)were of the appendix,and 34(23.0%)were of the pancreas.Successful followup was achieved with 123 patients.The average followup time was 29.77 months,with the time range being from 1 to 122 months. The 1-,3-,and 5-year overall survival rates of the followup patients were 92.7%,81.1%,and 75.9%,respectively.The 5-year survival rates corresponding to anatomical locations were stomach 46.4%,duodenum 83.3%,ampulla 80%,appendix 100%,colon 35.7%,rectum 81.5%,and pancreas 89.4%.Based on patient age,sex,local progression,lymph node metastasis,distant metastasis,vascular invasion,and Ki-67 index,the survival curve was analyzed by the log-rank test.Single-factor analysis suggest that age,local progression,lymph node metastasis,distant location,metastasis,vascular invasion,and Ki-67 index were risk factors.Multivariate analysis of these factors showed that age,local progression,and distant metastasis were independent risk factors.Log-rank test was performed on the survival curves of NET G3 and neuroendocrine carcinoma(NEC)cases,and no significant difference was demonstrated.Conclusions: This study constitutes a comprehensive analysis of the clinical features of GEP-NENs in a Chinese population.The incidence of NENs has risen substantially.The most common tumor sites were the stomach,the rectum,and the pancreas.The NENs derived from stomach and colon have a worse prognosis compared to other anatomical sites.Patient age,local progress,lymph node metastasis,and pathological classification of tumor are predictors for poor prognosis.The classification of NET G3 in GEP-NENs was not considered statistically significant compared with NEC.