Clinicopathologic Features of Gastroenteropancreatic Neuroendocrine Tumors: A Single-center Experience

Clinicopathologic Features of Gastroenteropancreatic Neuroendocrine Tumors: A Single-center Experience

Background: Gastroenteropancreatic neuroendocrine tumors, aheterogeneous group of neoplasms, originates from the neuroendocrinesystem of the gastrointestinal tract and pancreas. There are limitednumber of studies investigating neuroendocrine tumors in Turkey.Aims: To define the clinicopathologic, demographic, and survivalfeatures of patients with gastroenteropancreatic neuroendocrinetumors.Study Design: A retrospective observational cohort study.Methods: We reviewed hospital records of patients and data wasanalyzed retrospectively. We investigated the clinical, pathological,survival features, and prognosis of patients with gastroenteropancreaticneuroendocrine tumors (n=128) admitted to the medical oncologydepartment between year 2003 and 2014. Survival estimation wasperformed by the Kaplan-Meier method. Univariate and multivariateCox regression models were utilized to investigate the prognosticfactors for survival.Results: Of 128 patients with gastroenteropancreatic neuroendocrinetumors, 61 (47.7%) were female and 67 (52.3%) were male. Themost common site of the tumor was stomach (36.7%), while themost common stage of tumor at diagnosis was stage 4 (40.9%). Themedian follow-up period was 37 months, while the 3- and 5-yearoverall survival rates were 78% and 69%, respectively. The factorssignificantly affecting overall survival rate were clinical stage, grade,presence of metastasis at diagnosis, and Ki-67 proliferation index.These factors were associated with the 3- and 5-year overall survivalrate. Moreover, grade (hazard ratio: 8.34, 95% confidence interval:2.16-32.22, p=0.01) and presence of metastasis at diagnosis (hazardratio: 3.18, 95% confidence interval: 1.30-7.77, p=0.01) independentlypredicted overall survival in multivariate model following adjustmentfor age and gender.Conclusion: Higher-grade and presence of metastasis at diagnosis arenegative independent prognostic indicators of survival in patients withgastroenteropancreatic neuroendocrine tumors.

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  • 1. Oberg K. Neuroendocrine gastrointestinal tumors-a condensed overview of diagnosis and treatment. Ann Oncol 1999;10(Suppl 2):3-8.
  • 2. Garcia-Carbonero R, Capdevila J, Crespo-Herrero G, Díaz-Pérez JA, Martínez Del Prado MP, Alonso Orduña V, et al. Incidence, patterns of care and prognostic factors for outcome of gastroenteropancreatic neuroendocrine tumors (GEP-NETs): results from the National Cancer Registry of Spain (RGETNE). Ann Oncol 2010;21:1794- 803.
  • 3. Yao JC, Hassan M, Phan A, Dagohoy C, Leary C, Mares JE, et al. One hundred years after "carcinoid": epidemiology of and prognostic factors for neuroendocrine tumors in 35,825 cases in the United States. J Clin Oncol 2008;26:3063-72.
  • 4. Auernhammer CJ, Göke B. Therapeutic strategies for advanced neuroendocrine carcinomas of jejunum/ileum and pancreatic origin. Gut 2011;60:1009-21.
  • 5. Lepage C, Rachet B, Coleman MP. Survival from malignant digestive endocrine tumors in England and Wales: a population-based study. Gastroenterology 2007;132:899-904.
  • 6. Pape UF, Berndt U, Müller-Nordhorn J, Böhmig M, Roll S, Koch M, et al. Prognostic factors of long-term outcome in gastroenteropancreatic neuroendocrine tumours. Endocr Relat Cancer 2008;15:1083-97.
  • 7. Klimstra DS, Modlin IR, Coppola D, Lloyd RV, Suster S. The pathologic classification of neuroendocrine tumors: a review of nomenclature, grading, and staging systems. Pancreas 2010;39:707-12.
  • 8. Rindi G, Arnold R, Bosman FT, Copella C, Klimstra DS, Klöppel G, et al. Nomenclature and classification of neuroendocrine neoplasms of the digestive system. In: Bosman TF, Carneiro F, Hruban RH, Theise ND, editors. WHO Classification of Tumours of the Digestive System, 4th ed. International Agency for Research on cancer (IARC), Lyon; 2010:13.
  • 9. Sorbye H, Welin S, Langer SW, Vestermark LW, Holt N, Osterlund P, et al. Predictive and prognostic factors for treatment and survival in 305 patients with advanced gastrointestinal neuroendocrine carcinoma (WHO G3): the NORDIC NEC study. Ann Oncol 2013;24:152-60.
  • 10. Basturk O, Yang Z, Tang LH, Hruban RH, Adsay V, McCall CM, et al. The highgrade (WHO G3) pancreatic neuroendocrine tumor category is morphologically and biologically heterogenous and includes both well differentiated and poorly differentiated neoplasms. Am J Surg Pathol 2015;39:683-90.
  • 11. Burnik FS, Yalcin S. NFKB1-94 insertion/deletion ATTG polymorphism in gastroenteropancreatic neuroendocrine tumors. Chemotherapy 2009;55:381-5.
  • 12. Jiao Y, Shi C, Edil BH, de Wilde RF, Klimstra DS, Maitra A, et al. DAXX/ATRX, MEN1, and mTOR pathway genes are frequently altered in pancreatic neuroendocrine tumors. Science 2011;331:1199-203.
  • 13. Yalcin S. Advances in the systemic treatment of pancreatic neuroendocrine tumors. Cancer Treat Rev 2011;37:127-32.
  • 14. Modlin IM, Lye KD, Kidd M. A 5-decade analysis of 13,715 carcinoid tumors. Cancer 2003;97:934-59.
  • 15. Van Gompel JJ, Sippel RS, Warner TF, Chen H. Gastrointestinal carcinoid tumors: factors that predict outcome. World J Surg 2004;28:387-92.
  • 16. Maggard MA, O'Connell JB, Ko CY. Updated population-based review of carcinoid tumors. Ann Surg 2004;240:117-22.
  • 17. Wang YH, Lin Y, Xue L, Wang JH, Chen MH, Chen J. Relationship between clinical characteristics and survival of gastroenteropancreatic neuroendocrine neoplasms: A single-institution analysis (1995-2012) in South China. BMC Endocr Disord 2012;12:30.
  • 18. Yalcin S, Shimon I, Stapleton GN, et al. Gastroenteropancreatic Neuroendocrine Tumors (GEPNET) Registry 2009-2018: Results of Collaborative Effort Including over 1000 Patients (Pts) with GEPNET from 15 Countries (Abstract D62, 16th Annual ENETS Conference)
  • 19. Dogan M, Yalcin B, Ozdemir NY, Arslan UY, Dogan L, Utkan G, et al. Retrospective analysis of seventy-one patients with neuroendocrine tumor and review of the literature. Med Oncol. 2012;29:2021-6.
  • 20. Varis K, Ihamäki T, Härkönen M, Samloff IM, Siurala M. Gastric morphology, function, and immunology in first-degree relatives of probands with pernicious anemia and controls. Scand J Gastroenterol 1979;14:129-39.
  • 21. Centanni M, Marignani M, Gargano L, Corleto VD, Casini A, Delle Fave G, et al. Atrophic body gastritis in patients with autoimmune thyroid disease: an underdiagnosed association. Arch Intern Med 1999;159:1726-30.
  • 22. Yalcin S, Bayram F, Erdamar S, Kucuk O, Oruc N, Coker A. Gastroenteropancreatic neuroendocrine tumors: recommendations of Turkish multidisciplinary neuroendocrine tumor study group on diagnosis, treatment and follow-up. Arch Med Sci 2017;13:271-82.
  • 23. Foltyn W, Zajęcki W, Marek B, Kajdaniuk D, Siemińska L, Zemczak A, et al. The value of the Ki-67 proliferation marker as a prognostic factor in gastroenteropancreatic neuroendocrine tumours. Endokrynol Pol 2012;63:362-6.
  • 24. Yucel B, Babacan NA, Kacan T, Eren AA, Eren MF, Bahar S, et al. Survival analysis and prognostic factors for neuroendocrine tumors in Turkey. Asian Pac J Cancer Prev 2013;14:6687-92.
  • 25. Esin E, Oksuzoglu B, Erdur E, Ozgun G, Demirci U. Well differentiated neuroendocrine tumors, a single center experience. J Oncol Sci 2018;4:119-24.
  • 26. Yildiz O, Ozguroglu M, Yanmaz T, Turna H, Serdengecti S, Dogusoy G. Gastroenteropancreatic neuroendocrine tumors: 10-year experience in a single center. Med Oncol 2010;27:1050-6.
Balkan Medical Journal-Cover
  • ISSN: 2146-3123
  • Başlangıç: 2015
  • Yayıncı: Erkan Mor
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