Lim Taekyu, Lee Jeeyun, Kim Jae J, Lee Jong Kyun, Lee Kyu Taek, Kim Young Ho, Kim Kwang-Won, Kim Sung, Sohn Tae Sung, Choi Dong Wook, Choi Seong Ho, Chun Ho-Kyung, Lee Woo Young, Kim Kyoung-Mee, Jang Kee-Taek, Park Young Suk
Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Asia Pac J Clin Oncol. 2011 Sep;7(3):293-9. doi: 10.1111/j.1743-7563.2011.01423.x.
We studied to identify the clinicopathological features, treatment outcome, and prognostic factors for patients with gastrointestinal and hepatopancreaticobiliary neuroendocrine tumor (NET).
Between February 2001 and May 2006, a total of 470 patients were diagnosed with NET arising from the gastrointestinal tract, pancreas, and hepatobiliary system. The retrospective patient cohort was obtained and analyzed.
The male to female ratio was 1.5:1, and the median age was 55 years (range, 16-81). The most common primary site was the rectum (55.8%). Overall 29 (6.2%) originated from the hepatobiliary system. At initial presentation, 60 patients (12.8%) showed distant metastases. Curative surgery or endoscopic resection was performed in 401 patients. Histopathological distributions were as follows: well differentiated tumor (82.1%), well differentiated carcinoma (10.2%) and poorly differentiated carcinoma (7.7%). The frequency of the poorly differentiated type was somewhat higher in the hepatobiliary system than in the pancreas and gastrointestinal tract (44.8, 15.4 and 2.8%, respectively, P < 0.05). The estimated 5-year overall survival rate for all patients was 89.6%. Multivariate analysis showed that distant metastases (P = 0.018), origin from the hepatobiliary system (P < 0.001) and poorly differentiated neuroendocrine carcinoma (P < 0.001) were independent predictors for poor survival outcome.
Patients with locoregional NET had a favorable long-term survival after curative resection. Distant metastases, hepatobiliary localization and a poor degree of tumor cell differentiation were poor prognostic factors. Further investigational approaches for treatment of advanced disease are needed.
我们旨在确定胃肠道和肝胆胰神经内分泌肿瘤（NET）患者的临床病理特征、治疗结果及预后因素。
2001年2月至2006年5月期间，共有470例患者被诊断为起源于胃肠道、胰腺和肝胆系统的NET。获取并分析了该回顾性患者队列。
男女比例为1.5:1，中位年龄为55岁（范围16 - 81岁）。最常见的原发部位是直肠（55.8%）。总体上，29例（6.2%）起源于肝胆系统。初诊时，60例患者（12.8%）出现远处转移。401例患者接受了根治性手术或内镜切除。组织病理学分布如下：高分化肿瘤（82.1%）、高分化癌（10.2%）和低分化癌（7.7%）。低分化类型在肝胆系统中的发生率略高于胰腺和胃肠道（分别为44.8%、15.4%和2.8%，P < 0.05）。所有患者的估计5年总生存率为89.6%。多因素分析显示，远处转移（P = 0.018）、起源于肝胆系统（P < 0.001）和低分化神经内分泌癌（P < 0.001）是生存预后不良的独立预测因素。
局限性NET患者根治性切除后长期生存良好。远处转移、肝胆定位及肿瘤细胞分化程度差是不良预后因素。需要进一步研究晚期疾病的治疗方法。
