Abstract
Purpose The objective of this study was to analyze the clinical features and prognosis of gastroenteropancreatic (GEP) neuroendocrine carcinomas (NECs) with liver metastasis and primary hepatic neuroendocrine carcinomas (PHNECs), as these rare hepatic neuroendocrine carcinomas have not been exhaustively studied. Methods The clinical data of 47 patients with hepatic NECs were retrospectively reviewed and categorized to analyze features and prognosis. Results The 47 studied cases comprised 13 cases of primary hepatic NECs (primary group) and 34 cases of metastatic hepatic NECs (metastatic group). Male patients were slightly dominant in both groups, while no age predilection was present. PHNECs were mostly single nodules located in the right lobe of the liver. Metastatic hepatic NECs originated mostly from the pancreas and stomach without distinction of the lobes of the liver. Univariate analysis showed that the treatment protocol (radical operation or others) was correlated with the overall survival (OS; p < 0.05) in the primary group, while treatment protocol and cytokeratin 7 (CK7) were associated with OS (p < 0.05) in the metastatic group. Cox proportional hazard regression showed that radical operation was an independent prognostic factor (p < 0.05) for OS in the metastatic group. Conclusions No significant differences in the clinicopathological features between PHNECs and metastatic hepatic GEP NECs were found, but radical operation was significantly correlated with OS for both carcinomas. Radical operation is the first choice for patients who are eligible for operation.
Highlights
Neuroendocrine tumors (NETs), known as amine precursor uptake decarboxylation (APUD) tumors, are an uncommon type of cancer originating from disseminated neuroendocrine cells
Among all reviewed 47 cases, 34 cases belonged to the metastatic group, and 13 cases belonged to the primary group
Most of the patients (22/34) had symptoms caused by tumor oppression, 10 cases had facial flushing, 8 cases had abdominal pain and diarrhea, and 5 cases had asthma
Summary
Neuroendocrine tumors (NETs), known as amine precursor uptake decarboxylation (APUD) tumors, are an uncommon type of cancer originating from disseminated neuroendocrine cells. NETs of the G1/G2 grade were regarded as well as differentiated. High-grade (G3) neoplasms have been regarded as synonymous with poorly differentiated NECs [1]. The liver is the common site for metastasis, yet it is an uncommon site for the origin of carcinomas [3]. Little is known about PHNECs, and the diagnosis of PHNECs is a problem worthy of discussion.
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