Clinicopathological Features and Prognosis of Gastroenteropancreatic Neuroendocrine Tumors: Analysis from a Single-institution

Background: The gastroenteropancreatic neuroendocrine neoplasm (GEP-NEN) is the most common typeof neuroendocrine neoplasm. We summarized data in our centre to investigate the clinicopathological features,diagnostic methods, therapeutic approaches and prognosis for this neoplasm to increase knowledge of thisdisease in Asian populations.
Method: A total of 122 patients treated at Sun Yet-san Memorial Hospital of SunYat-sen University between January 2000 and December 2011 were analyzed retrospectively.
Results: Pancreaswas the most common site of involvement (65/122, 53.3%); this disease has no special symptoms; positive ratesof chromogranin A (CgA) and synaptophysin (Syn) were 81.1% and 87.7%, respectively. The positive rate ofSyn had statistical difference among the three grades, but not CgA. Some 68 patients had G1 tumors, 32 G2tumors and 22 G3 tumors, and Chi-square test showed that higher grading was correlated with worse prognosis(χ2=32.825, P=0.0001). A total of 32 patients presented with distant metastasis, and 8 cases emerged duringfollowing up. Cox proportional hazards regression modeling showed that the tumor grade (P=0.01), lymphaticmetastasis (P=0.025) and distant metastasis (P=0.031) were predictors of unfavorable prognosis. The overall5-year survival rate was 39.6%, the 5-year survival rate of G1 was 55.7%, and the G2 and G3 were 34.2% and0%, respectively.
Conclusions: The incidence of gastroenteropancreatic neuroendocrine tumors has risen overthe last 12 years. All grades of these diseases metastasize readily, and further research regarding the treatmentof patients after radical surgery is needed to prolong disease-free survival.