Abstract
BackgroundTo assess the prognostic factors and investigate the optimal treatment of gastric mixed adenoneuroendocrine tumors.MethodsWe retrospectively analyzed clinical data from 80 patients with gastric mixed adenoneuroendocrine carcinoma that received radical resection in our department from January 2007 to December 2016. Risk factors for relapse and survival were analyzed using a multivariate Cox proportional hazards regression model. Gastric mixed adenoneuroendocrine carcinoma was divided into neuroendocrine carcinoma and adenocarcinoma based on the predominant type in the tumor.ResultsThe 3-year overall survival was 40% in the neuroendocrine carcinoma group and 75% in the adenocarcinoma group (P = 0.006). The neuroendocrine carcinoma (NEC)-dominant tumors and a Ki-67-positive index ≥60% were independent risk factors for worse overall survival. The 3-year recurrence-free survival was 33% in the neuroendocrine carcinoma group and 68% in the adenocarcinoma group. NEC-dominant tumors and a Ki-67-positive index ≥60% were independent risk factors for gastric mixed adenoneuroendocrine carcinoma recurrence. Patients in the adenocarcinoma group that received adjuvant chemotherapy exhibited significantly better overall survival than patients that did not receive chemotherapy (median survival time 43 months vs. 13 months, P = 0.026).ConclusionThe NEC-dominant tumors and a Ki-67-positive index ≥60% were significantly associated with worse survival and a higher recurrence rate for gastric mixed adenoneuroendocrine carcinoma patients. Patients in the adenocarcinoma group may benefit from gastric adenocarcinoma treatments.
Highlights
To assess the prognostic factors and investigate the optimal treatment of gastric mixed adenoneuroendocrine tumors
Clinicopathologic characteristics Eighty patients with Gastric mixed adenoneuroendocrine carcinomas (gMANECs) were enrolled in this study from January 2007 to December 2016; 44 were in the neuroendocrine carcinoma (NEC) group, and 36 were in the AC group
There was no significant difference between the two groups in terms of male-female ratio, American Society of Anesthesiologists (ASA) score, depth of invasion, lymph node metastasis, TNM stage or Ki-67-positive index, the NEC group exhibited larger tumor sizes
Summary
To assess the prognostic factors and investigate the optimal treatment of gastric mixed adenoneuroendocrine tumors. Gastric neuroendocrine tumors (gNETs) are rare neoplasms with significant heterogeneity that account for approximately 4.0% of all neuroendocrine tumors [1], and the incidence of gNET increases yearly [2, 3]. According to the 2010 WHO classification, gNET can be divided into neuroendocrine tumors, neuroendocrine carcinomas and. Xie et al BMC Cancer (2018) 18:1021. Cancer Network guidelines do not address gMANEC treatment, and factors affecting gMANEC prognosis and treatment have not yet been reported. We retrospectively investigated the clinicopathologic data of gMANEC after radical gastrectomy in a large-volume center to analyze prognostic factors and identify appropriate adjuvant treatments
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