Do neuroendocrine carcinomas and mixed neuroendocrine–non-neuroendocrine neoplasm of the gastrointestinal tract have the same prognosis? A SEER database analysis of 12,878 cases

Abstract

<jats:sec><jats:title>Background:</jats:title><jats:p> Neuroendocrine carcinomas (NECs) and mixed neuroendocrine–non-neuroendocrine neoplasm (MiNEN) in the gastrointestinal (GI) tract are both rare and malignant; however, it is unclear whether their prognosis is the same. </jats:p></jats:sec><jats:sec><jats:title>Methods:</jats:title><jats:p> In this cross-sectional study, a total of 12,878 patients with NEC or MiNEN in the GI tract were reviewed retrospectively by searching the Surveillance, Epidemiology, and End Results ( SEER) program database. Next, we compared the characteristics and survival between patients with NEC or MiNEN and further analyzed the prognostic factors for the patients. </jats:p></jats:sec><jats:sec><jats:title>Results:</jats:title><jats:p> The data showed that patients with MiNEN had a worse prognosis as compared with patients with pure NEC in the small intestine (SI) and appendix, whereas there was no significant survival difference between NEC and MiNEN in the other parts of the GI system. On the whole, age ⩾55 years ( p &lt; 0.0001), male ( p = 0.002), being diagnosed at TNM Stage II–IV ( p &lt; 0.0001) or not receiving surgical treatment ( p &lt; 0.0001) were the independent negative prognostic factors for NEC patients, whereas age ⩾55 years ( p = 0.003), being diagnosed at TNM Stage III–IV ( p &lt; 0.001) or not receiving surgical treatment ( p &lt; 0.001) were identified as the independent negative prognostic factors for the MiNEN patients. Furthermore, when NECs or MiNENs were classified based on the primary tumor site, the results showed that the prognostic factors for NEC and MiNEN varied between the tumor sites. </jats:p></jats:sec><jats:sec><jats:title>Conclusion:</jats:title><jats:p> The prognostic differences between NECs and MiNENs in the GI tract are heterogeneous and site-related. Patients with appendiceal or SI MiNEN have a poorer prognosis than patients with pure appendiceal or SI NEC. Therefore, we should pay more attention to patients with MiNEN in the SI and appendix and monitor them more closely. </jats:p></jats:sec>

A short report of 50 patients with gastroenteropancreatic mixed neuroendocrine–non-neuroendocrine neoplasms (MiNEN)

“…Based on our results, the prognosis of GEP MiNEN mirrors that of GEP NEC. A recent study showed that MiNEN has a worse prognosis compared with patients with pure NEC in the small intestine and in the appendix but no statistically significant difference in OS between the two in other parts of the GI-tract [12].…”

Neuroendocrine Neoplasms of the Gallbladder: A Clinicopathological Analysis of 13 Patients and a Review of the Literature

“…At present, prognostic factors for NENs are still controversial, and the prognosis depends not only on the stage of the disease but also on the exact histological type [47]. Shi et al considered that the survival time of patients with GB-MiNENs was similar to that of patients with GB-NECs [48]. Harada et al [21] concluded that the presence of the neuroendocrine tumor component of MiNENs in the biliary tract defines the prognosis.…”

When Variants Collide: An Unusual Presentation of Metastatic Gastric Mixed Neuroendocrine-Non-Neuroendocrine Neoplasm

“…Gastric MiNENs constitute a small fraction of digestive tumors, most commonly affecting men in their fifth or sixth decade. 4 , 5 The most extensive report on MiNEN trends comes from the Surveillance, Epidemiology, and End Results registry between 1975 and 2016. It reports an incidence of 5.6%, mostly in the appendix, colon, cecum, rectum, or small intestine.…”

“…It reports an incidence of 5.6%, mostly in the appendix, colon, cecum, rectum, or small intestine. 5 Compared with other tumors, gastric MiNENs are discovered at advanced stages, and very little is known about them.…”