In:
Cancer Medicine, Wiley, Vol. 7, No. 9 ( 2018-09), p. 4361-4370
Abstract:
Gastroesophageal Junction neuroendocrine neoplasms ( GEJ ‐ NEN s) are rare and heterogeneous tumors. We aim to analyze the clinicopathlogical features and prognostic factors of GEJ ‐ NEN s and to compare the outcome of GEJ ‐ NEN s with other gastric NEN s. Methods A total of 297 GEJ ‐ NEN s patients were enrolled from 10 Chinese hospitals and 3152 gastric NEN s patients, including 274 GEJ ‐ NEN s, were retrieved from Surveillance, Epidemiology, and End Results ( SEER ) database. Results The clinical characteristics of GEJ ‐ NEN s among different races were different. All Chinese patients had GEJ ‐ NEN s of grade 3, with 67.7% of poorly differentiated NEC and 32.3% of MANEC . In SEER database, 70.8% of white, 62.5% of black, and 87.5% of AP patients had poorly differentiated/undifferentiated tumors. In Cox multivariate analysis, NEC / MANEC ( HR 2.09, 95% CI 1.24‐3.56; P = 0.006), lymph node metastasis ( HR 3.52, 95% CI 1.68‐7.34; P = 0.001), and distant metastases ( HR 3.90, 95% CI 2.50‐6.08; P 〈 0.001) are independent predictors of overall survival. Surgical resection showed a median OS improvement of 13.1‐73.3 months ( HR 0.21, 95% CI 0.14‐0.33, P 〈 0.001). Adjuvant therapy did not improve survival for postoperative GEJ ‐ NEN patients ( P = 0.141). GEJ ‐ NEN s were larger, higher grade, more distant metastasis, and worse prognosis than other gastric NEN s. Conclusion GEJ ‐ NEN s were mostly poorly differentiated carcinomas, and all of Chinese patients were NEC / MANEC . The outcome of MANEC was preferable to NEC s. Both lymph nodes metastasis and distant disease were independent predictors of prognosis. Surgical resection can improve survival, but postoperative adjuvant therapy had no additional benefit. GEJ ‐ NEN s have worse survival than other gastric NEN s.
Type of Medium:
Online Resource
ISSN:
2045-7634
,
2045-7634
DOI:
10.1002/cam4.2018.7.issue-9
Language:
English
Publisher:
Wiley
Publication Date:
2018
detail.hit.zdb_id:
2659751-2
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