[Prognostic analysis of colon and rectal neuroendocrine neoplasm in different stages].

To explore the survival difference of patients with colon and rectal neuroendocrine neoplasm (NEN) at different stages. We identified 8 679 patients with colorectal NEN diagnosed between 1988 and 2014 from the Surveillance, Epidemiology, and End Results (SEER) registry, including 5 437 rectal NEN and 3 242 colon NEN ( 1 681 cecum NEN ). Survival curve was drawn by Kaplan-Meier method. Prognostic factors were analyzed by univariate analysis and multivariate Cox regression model. The ratio of male patients with colon and rectal NEN was similar to female (=0.095). Rectal NEN patients were younger (<0.001), more highly differentiated (<0.001), and with earlier stage (<0.001). Survival analysis showed that the survival of rectal NEN was superior to that of colon NEN, with 10-year tumor-specific survival rates of 86.8% and 44.8% respectively (<0.001). Multivariate Cox analysis showed that age, gender, marital status, primary tumor site, grade, stage and surgery were independent prognostic factors of colorectal NEN (all <0.01). The most important factor was stage (=3.531), followed by differentiation grade (=1.856). Stratified analysis displayed that the survival of rectal NEN in stage Ⅰ, Ⅱ and Ⅳ were better than those of corresponding stage of colon NEN (all <0.05), but worse in stage Ⅲ (=0.012). While the survival of rectal NEN were significantly better than those of colon NEN within all stages after excluding 1681 cases of cecal NEN (all <0.05). Among the patients with well-differentiated NEN, the survival of rectal NEN in stage Ⅰ, Ⅲ and Ⅳ were better than those of corresponding stage of colon NEN (all <0.05) while there was no significant difference in stage Ⅱ(=0.169). For poor-differentiated NEN, only the survival of rectal NEN patients in stage Ⅳ (=0.001) was significant longer than those of colon NEN, while there was no significant difference in stage Ⅰ, Ⅱ and Ⅲ (stage Ⅰ: =0.760; stage Ⅱ: =0.181; stage Ⅲ: =0.313). The survival of NEN patients in colon and rectum is different. Cecum NEN should be considered as a separated tumor for prognostic analysis due to its special clinicopathologic characteristics.