Comparison of Survival and Patterns of Recurrence in Gastric Neuroendocrine Carcinoma, Mixed Adenoneuroendocrine Carcinoma, and Adenocarcinoma

Ji, Lin; Zhao, Yajun; Zhou, Yan-bing; Tian, Yantao; He, Qingliang; Lin, Jie; Hao, Hankun; Zou, Bingbing; Jiang, Lixin; Zhao, Gang; Lin, Wei; Xu, Ying-Ying; Li, Zhi; Xue, Fangqin; Li, Shuliang; Fu, Weihua; Li, Yongxiang; Xu, Zekuan; Li, Yong; Chen, Jinping; Zhou, Xiaojun; Zhu, Zhenggang; Cai, Lisheng; Li, En; Li, Honglang; Zheng, Chao‐Hui; Li, Ping; Huang, Chang‐Ming; Xie, Jian‐Wei

doi:10.1001/jamanetworkopen.2021.14180

Cited by 37 publications

(38 citation statements)

References 32 publications

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“…Besides, recent studies indicated that poorly differential NENs had a good response to the chemotherapy, which might explain the better OS of patients with NENs [ 19 , 20 ]. Moreover, recent studies have reported that gastric NEC has unique clinicopathological features quite different from intestinal-type gastric cancer (IGC) and may have a superior survival to IGC in early-stage patients, indicating that NENs have better survival than other pathological types of cancers, like adenocarcinoma [ 21 , 22 ], which is consistent with our research.…”

Section: Discussionsupporting

confidence: 92%

The clinical and prognostic factors for biliary neuroendocrine neoplasm: a study based on the SEER database

et al. 2022

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Background In this study, we aimed at elucidating the postoperative survival and prognostic factors in patients with biliary neuroendocrine neoplasm (NEN). Methods Cases of biliary system NEN and adenocarcinoma from 1975 to 2016 were extracted from the Surveillance, Epidemiology, and End Results (SEER) database. A propensity score matching (PSM) method was used to adjust baseline differences in clinicopathological characteristics in our analysis. The Kaplan–Meier analysis was carried out for survival analysis. Results A total of 233 patients with biliary system NEN were enrolled in this study, of which 119 patients’ lesions located in gallbladder, while the others’ located in bile duct. The postoperative overall survival of bile duct NEN is significantly longer than that of gallbladder NEN (P < 0.001). For gallbladder NENs, surgery method (P = 0.020) and lymph node metastasis (P = 0.018) were identified as independent prognostic factors. In terms of ampulla of vater (AOV) NENs, age (P = 0.017) and lymph node metastasis (P = 0.006) were identified as independent prognostic factors, while grade (P = 0.002) and lymph node metastasis (P = 0.036) were identified as independent prognostic factors for extrahepatic bile duct (EBD) NENs. PSM analysis indicated that patients with biliary duct NENs have a better postoperative prognosis than biliary duct adenocarcinoma. Conclusions Patients with NEN have better overall survival than patients with adenocarcinoma. Gallbladder NEN has an adverse prognosis than that of biliary tract NEN. The pathological subtype, differentiation, lymph node metastasis, surgery method, and lymph node resection could affect the postoperative prognosis of the gallbladder and biliary tract NEN.

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Section: Discussionsupporting

confidence: 92%

The clinical and prognostic factors for biliary neuroendocrine neoplasm: a study based on the SEER database

et al. 2022

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“…A multicenter retrospective study included 503 patients with GNEC, 401 patients with MANEC and 2875 patients with gastric adenocarcinoma. After propensity score matching, the 5-year disease-free survival rates of GNEC and gastric adenocarcinoma were 47.6% vs 57.6%, respectively ( P < 0.001); the 5-year disease-free survival rates of MANEC and gastric adenocarcinoma were 51.1% and 57.8%, respectively ( P = 0.02)[ 26 ]. The high proportion of neuroendocrine components in MANEC often indicates poor prognosis[ 27 , 28 ].…”

Section: Discussionmentioning

confidence: 99%

Mixed large and small cell neuroendocrine carcinoma of the stomach: A case report and review of literature

Li¹,

Lu²,

Chen³

et al. 2022

WJCC

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BACKGROUND Gastric neuroendocrine carcinoma (GNEC) is a rare histological subtype of gastric cancer, which is categorized into small cell and large cell neuroendocrine carcinomas. It is characterized by strong invasiveness and poor prognosis. Mixed large and small cell neuroendocrine carcinoma (L/SCNEC) is an extremely rare pathological type of gastric cancer, and there have been no reports on this situation until now. CASE SUMMARY Herein, we first present a 57-year-old patient diagnosed with L/SCNEC of the stomach. A 57-year-old Chinese male presented with epigastric discomfort. Outpatient gastroscopic biopsy was performed, and pathological examination revealed that the cardia was invaded by adenocarcinoma. The patient underwent laparoscopic-assisted radical proximal subtotal gastrectomy and was diagnosed with L/SCNEC. He refused adjuvant treatment and was followed up every 3 mo. Eight months after the operation, the patient showed no evidence of local recurrence or distant metastasis. CONCLUSION We advocate conducting further genomic studies to explore the origin of gastric large cell and small cell neuroendocrine carcinoma and using different chemotherapy schemes according to large or small cell neuroendocrine carcinoma of the stomach for clinical research to clarify the heterogeneity of GNEC and improve the prognosis of patients with GNEC.

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“…Similar to these findings, in a recent study including 401 patients, the 5-year disease-free survival was 51.1%, which was significantly better than that of NEC (47,6%) and worse than that of adenocarcinoma (57,8%). Furthermore, in the same series, advanced stages and lymph node metastasis were independent risk factors related to distant recurrence[ 76 ].…”

Section: Organ-specific Clinicopathological Findingsmentioning

confidence: 99%

Mixed neuroendocrine–nonneuroendocrine neoplasms of the gastrointestinal system: An update

Elpek¹

2022

WJG

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Mixed neuroendocrine-nonneuroendocrine neoplasms (MiNENs) of the digestive tract are a rare heterogeneous group of tumors that present many challenges in terms of diagnosis and treatment. Over the years, the diagnostic criteria, classification, and clinical behavior of these tumors have been the subjects of ongoing debate, and the various changes in their nomenclature have strengthened the challenges associated with MiNENs. This review is performed to provide an understanding of the key factors involved in the evolution of the designation of these tumors as MiNEN, highlight the current diagnostic criteria, summarize the latest data on pathogenesis and provide information on available treatments. Moreover, this work seeks to increase the awareness about these rare neoplasms by presenting the clinicopathological features and prognostic factors that play important roles in their behavior and discussing their different regions of origin in the gastrointestinal system (GIS). Currently, the MiNEN category also includes tumors in the GIS with a nonneuroendocrine component and epithelial tumors other than adenocarcinoma, depending on the organ of origin. Diagnosis is based on the presence of both morphological components in more than 30% of the tumor. However, this value needs to be reconfirmed with further studies and may be a limiting factor in the diagnosis of MiNEN by biopsy. Furthermore, available clinicopathological data suggest that the inclusion of amphicrine tumors in the definition of MiNEN is not supportive and warrants further investigation. The diagnosis of these tumors is not solely based on immunohistochemical findings. They are not hybrid tumors and both components can act independently; thus, careful grading of each component separately is required. In addition to parameters such as the metastatic state of the tumor at the time of diagnosis and the feasibility of surgical resection, the aggressive potential of both components has paramount importance in the choice of treatment. Regardless of the organ of origin within the GIS, almost MiNENs are tumors with poor prognosis and are frequently encountered in the elderly and men. They are most frequently reported in the colorectum, where data from molecular studies indicate a monoclonal origin; however, further studies are required to provide additional support for this origin.

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Comparison of Survival and Patterns of Recurrence in Gastric Neuroendocrine Carcinoma, Mixed Adenoneuroendocrine Carcinoma, and Adenocarcinoma

Cited by 37 publications

References 32 publications

The clinical and prognostic factors for biliary neuroendocrine neoplasm: a study based on the SEER database

The clinical and prognostic factors for biliary neuroendocrine neoplasm: a study based on the SEER database

Mixed large and small cell neuroendocrine carcinoma of the stomach: A case report and review of literature

Mixed neuroendocrine–nonneuroendocrine neoplasms of the gastrointestinal system: An update

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