Survival Analysis in Gastrointestinal Neuroendocrine Carcinoma With Bone Metastasis at Diagnosis.

Genlian Chen,Shengjun Qian,Shicheng Wang,Qiang Xu,Zhan Wang

doi:10.3389/fsurg.2022.820725

Abstract

PurposeGastrointestinal neuroendocrine carcinoma (NEC) with bone metastasis is rarely reported. The purpose of this study is to explore the prognosis and risk factors of such patients.Patients and MethodsWe retrospectively reviewed patients diagnosed as gastrointestinal NECs with bone metastasis at diagnosis from 2010 to 2016 by using the Surveillance, Epidemiology and End Results (SEER) database. Predictors of overall survival (OS) and cancer-specific survival (CSS) were analyzed by univariable and multivariable Cox analyses. Kaplan–Meier plots were constructed to show the correlation between independent predictors and survival.ResultsA total of 330 gastrointestinal NEC patients with bone metastasis at diagnosis were included for analysis. Over half of patients were male and older than 60 years old. The most common primary site of gastrointestinal NEC with bone metastasis was the pancreas. The prognosis of gastrointestinal NEC with bone metastasis (3-year OS and CSS rates: 16.7 and 17.0%) was very poor. On Cox multivariable analysis, age over 60 years old, no surgery, and lung metastasis were independent predictors of decreased OS and CSS.ConclusionsWe identified three independent factors associated with prognosis among gastrointestinal NEC patients with bone metastasis, namely age, surgery, and lung metastasis. For younger gastrointestinal NEC patients with bone metastasis, surgical resection of primary tumors as well as actively treating lung metastasis might be useful for prolonging survival.

Highlights

Neuroendocrine carcinoma (NEC) is a poorly differentiated subtype of neuroendocrine neoplasms (NENs) according to the 2019 World Health Organization (WHO) classification [1]
This study retrospectively reviewed patients diagnosed as gastrointestinal NECs with bone metastasis at presentation by using the U.S National Cancer Institute’s SEER database (Version 8.3.8) between 2010 and 2016
Marital status had no association with survival in this study. In accordance with these findings, we suggested that for younger gastrointestinal NEC patients with bone metastasis, surgical resection of primary tumors as well as actively treating lung metastasis might be useful for prolonging survival

Summary

Introduction

Neuroendocrine carcinoma (NEC) is a poorly differentiated subtype of neuroendocrine neoplasms (NENs) according to the 2019 World Health Organization (WHO) classification [1]. NECs are commonly considered as rare, they have a rising incidence in recent years [2,3,4]. NECs are characterized by poorly differentiated morphology as well as a high proliferation capacity (Ki−67 proliferation index > 20%) [5]. Lung is the common site of NECs, while. Metastatic Gastrointestinal Neuroendocrine Carcinoma gastrointestinal NECs are rarely seen and account for about 35– 55% of all extra-pulmonary NECs [9]. Gastrointestinal NECs mainly arise from the esophagus, stomach, pancreas, colon and rectum and common metastatic sites for NECs include liver, lung and bone [8, 10]

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