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Şentürk M, Acar B, Yildirim MA, Çakir M, Küçükkartallar T, Vatansev C. Clinicopathological Characteristics of Gastroenteropancreatic Neuroendocrine Tumors: 10 Years of Experience From a Single Center. Pancreas 2022; 51:159-163. [PMID: 35404891 DOI: 10.1097/mpa.0000000000001981] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVES Gastorenteropancreatic neuroendocrine (GEP-NET) tumors are the second most common tumors of the gastrointestinal tract. We aimed to investigate the clinicopathological features and factors affecting the prognosis of patients with GEP-NET. METHODS Clinicopathological features of 158 patients were evaluated, including tumor location, TNM stage and grade, pathological features, presence of lymph nodes and distant metastases at the time of diagnosis, maximum tumor diameter and treatment details. Also, follow-up information was analyzed to discover possible prognostic factors. RESULTS The most common primary site is pancreas (45.6%, n = 72). Most of the GEP-NETs were nonfunctional (93.6%, n = 148). Of the 158 patients, 94 (59.5%) were grade 1, 46 (29.1%) grade 2, and 18 (11.4%) grade 3. The 1-year, 3-year, and 5-year survival rates were 82.3% (130/158), 61.4% (70/114), and 47.2% (35/74), respectively. In multivariate analysis, histological grade (P = 0.04) and TNM stage (P < 0.001) were independent prognostic factors for survival in patients with GEP-NET. CONCLUSIONS They are increasing in frequency and are the most common tumors in the pancreas. Nonfunctional tumors made up the majority of cases. The main treatment was surgical resection. Histological grade and TNM stage are independent prognostic factors.
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Affiliation(s)
- Mustafa Şentürk
- From the Department of General Surgery, Necmettin Erbakan University Meram Faculty of Medicine, Konya, Turkey
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Michael M, Thursfield V, Te Marvelde L, Kong G, Hicks RJ. Incidence, prevalence, and survival trends for neuroendocrine neoplasms in Victoria, Australia, from 1982 to 2019: Based on site, grade, and region. Asia Pac J Clin Oncol 2021; 18:e306-e317. [PMID: 34821050 DOI: 10.1111/ajco.13671] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Accepted: 08/17/2021] [Indexed: 11/28/2022]
Abstract
AIMS Neuroendorcine neoplasms (NENs) are rare tumors characterised by variable biology and delayed diagnosis. Several population studies have reported a marked increased incidence over time. The objectives of this analysis were to describe within Victoria (the second largest Australian state, 6.4 Million) the trends for NENs incidence/survival over nearly 38 years (1982-2019), and regional differences in survival. METHODS All NEN cases were identified from the Victorian Cancer Registry over four time periods: 1982-1989, 1990-1999, 2000-2009, and 2010-2019. Data collected included primary tumor site, histological grade, gender, overall survival (OS), and place of residence. Incidence data were analyzed with the generation of annual standardized rates (ASR). OS was assessed for the entire cohort and between geographical regions. RESULTS The overall NEN population (1982-2019) included 8,106 patients: over 60% grade 1/2 NENs, especially small bowel and colorectal. The number of new diagnoses increased over three-fold over time for the overall cohort and by tumoral categories. The ASR increased similarly, especially pancreatic NENs (4.3-fold) and differed between genders. The 5-year OS rates and median OS increased over time for the overall cohort: from 52% to 67% (p < 0.001). OS was greater for NEN patients residing in major cities relative to regional/remote areas (p = 0.01). CONCLUSION This population-wide analysis with over 38 years of data has confirmed the international trends of the increased incidence, prevalence, and OS of NEN patients regardless of primary site or histological grade. The analysis also observed a difference in survival outcome in rural/remote versus urban areas.
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Affiliation(s)
- M Michael
- Neuroendocrine Tumour Service, a European Neuroendocrine Tumor Society Centre of Excellence, Peter MacCallum Cancer Centre, Melbourne, Australia.,Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, Australia.,Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, Australia
| | - V Thursfield
- Victorian Cancer Registry, Cancer Council Victoria, Melbourne, Australia
| | - L Te Marvelde
- Victorian Cancer Registry, Cancer Council Victoria, Melbourne, Australia
| | - G Kong
- Neuroendocrine Tumour Service, a European Neuroendocrine Tumor Society Centre of Excellence, Peter MacCallum Cancer Centre, Melbourne, Australia.,Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, Australia.,Nuclear Medicine Department, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - R J Hicks
- Neuroendocrine Tumour Service, a European Neuroendocrine Tumor Society Centre of Excellence, Peter MacCallum Cancer Centre, Melbourne, Australia.,Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, Australia.,Nuclear Medicine Department, Peter MacCallum Cancer Centre, Melbourne, Australia
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Yu YJ, Li YW, Shi Y, Zhang Z, Zheng MY, Zhang SW. Clinical and pathological characteristics and prognosis of 132 cases of rectal neuroendocrine tumors. World J Gastrointest Oncol 2020; 12:893-902. [PMID: 32879666 PMCID: PMC7443838 DOI: 10.4251/wjgo.v12.i8.893] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Revised: 05/26/2020] [Accepted: 07/19/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Neuroendocrine tumors (NETs) frequently occur in the gastrointestinal tract, lung, and pancreas, and the rectum and appendix are the sites with the highest incidence. Epidemiology statistics show that an estimated 8000 people every year in the United States are diagnosed with NETs occurring in the gastrointestinal tract, including the stomach, intestine, appendix, colon, and rectum. The pathological changes and clinical symptoms of NETs are not specific, and therefore they are frequently misdiagnosed. AIM To investigate the clinical symptoms, pathological characteristics, treatment, and prognosis of rectal neuroendocrine tumors (RNETs) by analyzing the clinical and pathological data of 132 RNET cases at our hospital. METHODS All RNETs were graded according to Ki-67 positivity and mitotic events. The tumors were staged as clinical stages I, II, III, and IV according to infiltrative depth and tumor size. COX proportional hazard model was used to assess the main risk factors for survival. RESULTS These 132 RNETs included 83 cases of G1, 21 cases of G2, and 28 cases of G3 (neuroendocrine carcinoma) disease. Immunohistochemical staining showed that 89.4% of RNETs were positive for synaptophysin and 39.4% positive for chromogranin A. There were 19, 85, 23, and 5 cases of clinical stages I, II, III, and IV, respectively. The median patient age was 52.96 years. The diameter of tumor, depth of invasion, and pathological grade were the main reference factors for the treatment of RNETs. The survival rates at 6, 12, 36, and 60 mo after operation were 98.5%, 94.6%, 90.2%, and 85.6%, respectively. Gender, tumor size, tumor grade, lymph node or distant organ metastasis, and radical resection were the main factors associated with prognosis of RNETs. Multivariate analysis showed that tumor size and grade were independent prognostic factors. CONCLUSION The clinical symptoms of RNETs are not specific, and they are easy to misdiagnose. Surgery is the main treatment method. The grade and stage of RNETs are the main indices to evaluate prognosis.
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Affiliation(s)
- Yong-Jun Yu
- Department of Colorectal Surgery, Tianjin Union Medical Center, Tianjin 300121, China
| | - Yu-Wei Li
- Department of Colorectal Surgery, Tianjin Union Medical Center, Tianjin 300121, China
| | - Yang Shi
- Department of Colorectal Surgery, Tianjin Union Medical Center, Tianjin 300121, China
| | - Zhao Zhang
- Department of Colorectal Surgery, Tianjin Union Medical Center, Tianjin 300121, China
| | - Min-Ying Zheng
- Department of Pathology, Tianjin Union Medical Center, Tianjin 300121, China
| | - Shi-Wu Zhang
- Department of Pathology, Tianjin Union Medical Center, Tianjin 300121, China
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Liu H, Xie R, Zhao Z, Xu D, Yang K, Ding M, Tan D, Liao W, Han X, Zhang J, Shen D, Yuan J, Xu Z, Fei J. An 11-year retrospective study: clinicopathological and survival analysis of gastro-entero-pancreatic neuroendocrine neoplasm. Medicine (Baltimore) 2020; 99:e21682. [PMID: 32872039 PMCID: PMC7437823 DOI: 10.1097/md.0000000000021682] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2020] [Revised: 06/30/2020] [Accepted: 07/10/2020] [Indexed: 12/02/2022] Open
Abstract
To investigate the clinicopathological characteristics and relevant prognostic factors of gastro-entero-pancreatic neuroendocrine neoplasm (GEP-NEN), to improve our understanding of GEP-NEN.This was a retrospective analysis of 155 patients (average age 53.7 ± 13.6 years) pathologically diagnosed with GEP-NEN. We analyzed the clinicopathological characteristics, treatment, and prognostic factors of GEP-NEN.The most common primary site was the pancreas (41.9%), followed by the rectum, stomach and duodenum. Most cases were nonfunctional GEP-NENs (149/155) with nonspecific symptoms. TNM stage and histological grade were determined by the latest criteria. Surgical resection was the mainstay of treatment in 150 patients, and 22 patients received chemotherapy under different circumstances. A total of 130 patients were followed up for a median of 44 months, and 1-year and 3-year survival rates were 82.3% and 72.3%, respectively. According to univariate and multivariate analysis, incidental diagnosis, maximum tumor diameter, tumor stage, lymph node and distant metastasis, TNM stage, and histological grade were significantly correlated with overall survival, but histological grade was the only factor confirmed as an independent prognostic factor for long-term survival of GEP-NEN.GEP-NEN, with an increasing trend in incidence, occurred most frequently in the pancreas. Nonfunctional tumors with nonspecific symptoms comprised the majority of cases. The main treatment was surgical resection. Histological grade was confirmed as the only independent prognostic factor.
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Affiliation(s)
- Hua Liu
- Department of General Surgery, Ruijin Hospital/Lu Wan Branch, Shanghai Jiao Tong University, School of Medicine
- Division of Gastroenterology and Hepatology, Renji Hospital, Shanghai Jiao Tong University, School of Medicine
| | - Rongli Xie
- Department of General Surgery, Ruijin Hospital/Lu Wan Branch, Shanghai Jiao Tong University, School of Medicine
- Department of Surgery, Luwan Branch, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zhifeng Zhao
- Department of General Surgery, Ruijin Hospital/Lu Wan Branch, Shanghai Jiao Tong University, School of Medicine
| | - Dan Xu
- Department of General Surgery, Ruijin Hospital/Lu Wan Branch, Shanghai Jiao Tong University, School of Medicine
| | - Kaige Yang
- Department of General Surgery, Ruijin Hospital/Lu Wan Branch, Shanghai Jiao Tong University, School of Medicine
| | - Min Ding
- Department of General Surgery, Ruijin Hospital/Lu Wan Branch, Shanghai Jiao Tong University, School of Medicine
| | - Dan Tan
- Department of Surgery, Luwan Branch, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Wenqiang Liao
- Department of Surgery, Luwan Branch, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xujie Han
- Department of Surgery, Luwan Branch, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jun Zhang
- Department of General Surgery, Ruijin Hospital/Lu Wan Branch, Shanghai Jiao Tong University, School of Medicine
| | - Dongjie Shen
- Department of Surgery, Luwan Branch, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jianmin Yuan
- Department of Surgery, Luwan Branch, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zhiwei Xu
- Department of General Surgery, Ruijin Hospital/Lu Wan Branch, Shanghai Jiao Tong University, School of Medicine
| | - Jian Fei
- Department of General Surgery, Ruijin Hospital/Lu Wan Branch, Shanghai Jiao Tong University, School of Medicine
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Trends in diagnosis of gastroenteropancreatic neuroendocrine tumors (GEP-NETs) in India: A report of multicenter data from a web-based registry. Indian J Gastroenterol 2017; 36:445-451. [PMID: 29457213 DOI: 10.1007/s12664-017-0808-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2016] [Accepted: 12/16/2017] [Indexed: 02/04/2023]
Abstract
INTRODUCTION Gastroenteropancreatic neuroendocrine tumors (GEP-NETs) are rare tumors. We report data of 407 GEP-NET cases from a neuroendocrine tumor (NET) registry in India. METHODS The AP-NET registry is an open-label, multicenter, longitudinal observational registry of patients with GEP-NETs in which six tertiary care oncology centers contributed data. Data was prospectively entered in a dedicated computerized database and was reviewed retrospectively. The patients were divided into three cohorts-those diagnosed from 2001 to 2005, from 2006 to 2010, and from 2011 to 2016. RESULTS Of the 407 cases registered, 37 were in Cohort I, 136 in Cohort II, and 234 in Cohort III. Majority were symptomatic with only 98 patients (24.0%) asymptomatic. The most common presentation of non-functional tumors was abdominal pain (42.4%), while functional tumors presented most commonly with carcinoid syndrome. Use of DOTA-PET, introduced in 2011, has increased evaluation in 33.3% patients in Cohort III. The most common primary site was pancreas in all three cohorts. Male preponderance (58.3%) was seen. Histopathological grading was obtained in 230 (56.5%) patients-118 (29%) Grade I, 74 (18.2%) Grade II, and 36 (8.8%) Grade III NET. CONCLUSION This report highlights changing trends in the diagnosis and reporting of NETs over the last 15 years.
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Abstract
AIMS Neuroendocrine gastroenteropancreatic tumors are infrequently found neoplasms. Our objective was to analyze the survival rates for all sites that they occur in by studying different variables. MATERIALS AND METHODS A retrospective study was carried out using records for a 7-year period from January 1, 2008 to December 31, 2014 on neuroendocrine gastroenteropancreatic tumors patients diagnosed at the Pontevedra-Salnés Hospital Complex. The variables used were as follows: age at diagnosis, tumor size, presence or absence of metastases at diagnosis, cell proliferation index, Ki-67 of each tumor, treatments received, postdiagnosis survival time, existence or not of tumor progression, and time from diagnosis to progression and from diagnosis to mortality. In relation to treatments, the information recorded was whether the treatment was endoscopic, surgical, or pharmacological. RESULTS Ninety-three neuroendocrine tumors made up a ratio of 4.42 cases per 100,000 inhabitants per annum. The median patient follow-up time was 44 months. The overall 5-year survival rate for patients who were followed up for a minimum of 60 months (49 patients) was 65.3%. The progression-free survival was 75.6% for 41 patients who were followed up for a minimum of 60 months. The survival rate for patients receiving endoscopic treatment was 100%, as there was no patient mortality recorded for those treated by endoscopic resection during the follow-up period. CONCLUSION Pancreatic neuroendocrine tumors may be managed conservatively in elderly patients by either monitoring them with imaging studies or treating them with somatostatin analogs. In the case of digestive tract tumors (stomach, duodenum, and rectum) that meet the criteria for endoscopic resection, this is a reliable and safe technique in the long term.
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