Cen Dong, Liu Hui, Wan Zhe, Lin Zhongjie, Wang Yanting, Xu Junjie, Liang Yuelong
Key Laboratory of Laparoscopic Technology of Zhejiang Province, Sir Run-Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Department of General Surgery, Sir Run-Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Endocr Connect. 2019 Sep;8(9):1273-1281. doi: 10.1530/EC-19-0124.
Gallbladder neuroendocrine neoplasm (GB-NEN) is a relatively rare neoplasm, accounting for 0.5% of all neuroendocrine neoplasm cases and 2.1% of gallbladder cancers. Because of the limited understanding of GB-NEN, the aim of this study was to explore the clinicopathology and survival of GB-NEN patients selected from the Surveillance, Epidemiology, and End Results (SEER) database.
A total of 248 GB-NEN patients from the SEER database diagnosed between 2004 and 2015 were included. Kaplan-Meier curves were used to examine the survival time. Multivariate Cox proportional hazard models were used to estimate hazard ratios with 95% confidence intervals to analyze the impact of factors on overall survival and cancer-specific survival.
The majority of the GB-NEN patients were women (67.3%), white (77%), and married (61.7%). Most tumors were <2 cm in size (31.0%), G3 stage (25.8%), and distant SEER stage (41.1%). 62.9% and 64.5% of cases showed an absence of lymph node metastasis and tumor metastasis, respectively. Patients who received gallbladder surgery had significantly better survival outcomes (P < 0.001). However, patients who received both gallbladder surgery and lymph node resection did not have better survival outcome compared with patients who received only gallbladder surgery. Multivariate Cox proportional hazard models indicated that older age, unmarried status, large tumor size (>5 cm), and distant SEER stage were significant independent predictors for decreased overall survival time and cancer-specific survival time (P < 0.05).
Age, marital status, tumor size, and SEER stage were predictors for the survival of GB-NEN patients. Gallbladder surgery was associated with better survival, but the combination of gallbladder surgery and lymphadenectomy had no effect on survival outcomes.
胆囊神经内分泌肿瘤（GB-NEN）是一种相对罕见的肿瘤，占所有神经内分泌肿瘤病例的0.5%，占胆囊癌的2.1%。由于对GB-NEN的了解有限，本研究的目的是探讨从监测、流行病学和最终结果（SEER）数据库中选取的GB-NEN患者的临床病理特征和生存率。
纳入2004年至2015年间在SEER数据库中诊断的248例GB-NEN患者。采用Kaplan-Meier曲线检查生存时间。使用多变量Cox比例风险模型估计风险比及95%置信区间来分析各因素对总生存和癌症特异性生存的影响。
大多数GB-NEN患者为女性（67.3%）、白人（77%）且已婚（61.7%）。大多数肿瘤大小<2 cm（31.0%）、G3期（25.8%）且SEER远处分期（41.1%）。分别有62.9%和64.5%的病例无淋巴结转移和肿瘤转移。接受胆囊手术的患者生存结局明显更好（P<0.001）。然而与仅接受胆囊手术的患者相比，接受胆囊手术加淋巴结切除的患者生存结局并未更好。多变量Cox比例风险模型表明，年龄较大、未婚状态、肿瘤较大（直径>5 cm）和SEER远处分期是总生存时间和癌症特异性生存时间降低的显著独立预测因素（P<0.05）。
年龄、婚姻状况、肿瘤大小和SEER分期是GB-NEN患者生存的预测因素。胆囊手术与更好的生存相关，但胆囊手术和淋巴结清扫联合对生存结局无影响。
