Abstract
PurposeThis study aimed to investigate the characteristics of colonic neuroendocrine neoplasms (NENs) and to validate the prognostic value of the European Neuroendocrine Tumor Society (ENETS) and American Joint Committee on Cancer (AJCC) 8th staging systems.MethodsA total of 167 and 1248 patients with colonic NENs from 12 medical centers across China and from the Surveillance, Epidemiology, and End Results (SEER) cancer registry in the United States, respectively, were reviewed. Patients were staged according to the ENETS and AJCC 8th staging systems.ResultsClinicopathological features of colonic NENs in the Chinese cohort and SEER cohort were significantly distinct. In both the Chinese cohort and the SEER cohort, colonic neuroendocrine carcinoma (NEC) and mixed adeno‐neuroendocrine carcinoma (MANEC) were more frequent in the midgut than in the hindgut. Tumors originating from the midgut tended to be larger and at a more advanced stage than those from the hindgut. The AJCC 8th staging system and the ENETS system appeared to have similar prognostic ability for colonic NEC/MANEC.ConclusionsOur study revealed that tumors originating from the midgut and the hindgut shared different clinicopathological features. The AJCC 8th staging system and the ENETS system appeared to have similar prognostic ability for colonic NEC/MANEC.
Highlights
Neuroendocrine neoplasms (NENs) are rare neoplasms with great heterogeneity that originate from peptidergic neurons and neuroendocrine cells throughout the body
In 2007, the European Neuroendocrine Tumor Society (ENETS) first proposed a formal TNM system for colorectal neuroendocrine neoplasms (Appendices),[13] which was adopted by the American Joint Committee on Cancer (AJCC) for the 7th edition of its staging manual in 2010.14 The AJCC published the 8th edition of the staging manual in 2016 (Appendices);[15] in this new version, guidelines for colonic neuroendocrine carcinoma (NEC)/mixed adeno‐neuroendocrine carcinoma (MANEC) followed those for colonic adenocarcinoma, while guidelines for well or moderately differentiated colonic neuroendocrine tumor (NET) remained the same as in the ENETS system
The clinical features of colonic NENs in the midgut and hindgut, and comparison of the prognostic efficacy of the ENETS and AJCC 8th staging systems were similar in the two cohorts, which may partly reflect the reliability of the results in the current study
Summary
Neuroendocrine neoplasms (NENs) are rare neoplasms with great heterogeneity that originate from peptidergic neurons and neuroendocrine cells throughout the body. Given the rarity of colonic NENs, a population‐based study is urgently needed to provide an overview of the clinicopathological features and survival of this rare subtype of NENs. The primary aim of the current study was to investigate the clinicopathological features of patients with colonic NENs. In 2007, the European Neuroendocrine Tumor Society (ENETS) first proposed a formal TNM system for colorectal neuroendocrine neoplasms (Appendices),[13] which was adopted by the American Joint Committee on Cancer (AJCC) for the 7th edition of its staging manual in 2010.14 The AJCC published the 8th edition of the staging manual in 2016 (Appendices);[15] in this new version, guidelines for colonic NEC/MANEC followed those for colonic adenocarcinoma, while guidelines for well or moderately differentiated colonic NET remained the same as in the ENETS system. No studies have compared the prognostic validity of the ENETS and AJCC 8th staging system in colonic NEC/MANEC. The second aim of the current study was to validate the prognostic value of the ENETS and AJCC 8th staging systems for colonic NENs
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