Wu Zijian, Wang Zhijie, Zheng Zhaoxu, Bi Jianjun, Wang Xishan, Feng Qiang
Department of Colorectal Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China.
Cancer Manag Res. 2020 Aug 11;12:7151-7164. doi: 10.2147/CMAR.S256723. eCollection 2020.
The aim of our study was to analyze the factors affecting lymph node metastasis (LNM) and the prognosis of colorectal neuroendocrine tumors (NETs).
A retrospective analysis was conducted to collect the clinical data of 135 patients with colorectal NETs from January 2000 to December 2018, including clinical manifestations, pathological results, treatment methods, etc. Follow-up was regularly performed to observe the recurrence and metastasis of tumors and to identify the clinical and pathological features of colorectal NETs, risk factors for LNM and survival outcomes.
Among 135 patients, there were 57 (42.2) patients with LNM, and the independent risk factors for LNM in the multivariable analyses were tumor diameter ≥2 cm ( 0.040) and tumor grade G3 (=0.001). Patients were followed up for 1 to 190 months, and of the 133 patients who were successfully followed up, the 5-year OS was 71.7%, and the 5-year PFS was 69.0%. The multivariate analysis for survival outcomes showed that age ≥65 years (=0.002/<0.001) and lymph node metastasis (=0.018/0.025) were independent risk factors affecting 5-year PFS and OS in colorectal neuroendocrine tumors. Tumors in the colon (=0.022), moderately positive (++) CgA (=0.010) and strongly positive (+++) CgA (=0.007) were independent risk factors for poor 5-year PFS in patients with colorectal NETs.
Rectal NETs have a better prognosis than colonic neuroendocrine tumors. Tumor diameter and tumor grade are independent risk factors for LNM in colorectal neuroendocrine tumors. Age, tumor location, lymph node status and a positive level of the neuroendocrine marker CgA are independent risk factors that affect the prognosis of colorectal NETs.
本研究旨在分析影响结直肠神经内分泌肿瘤（NETs）淋巴结转移（LNM）及预后的因素。
进行回顾性分析，收集2000年1月至2018年12月期间135例结直肠NETs患者的临床资料，包括临床表现、病理结果、治疗方法等。定期进行随访，观察肿瘤的复发和转移情况，明确结直肠NETs的临床和病理特征、LNM的危险因素及生存结局。
135例患者中，有57例（42.2%）发生LNM，多变量分析中LNM的独立危险因素为肿瘤直径≥2 cm（P = 0.040）和肿瘤分级G3（P = 0.001）。患者随访1至190个月，在133例成功随访的患者中，5年总生存率（OS）为71.7%，5年无进展生存率（PFS）为69.0%。生存结局的多变量分析显示，年龄≥65岁（P = 0.002/<0.001）和淋巴结转移（P = 0.018/0.025）是影响结直肠神经内分泌肿瘤5年PFS和OS的独立危险因素。结肠肿瘤（P = 0.022）、嗜铬粒蛋白A（CgA）中度阳性（++）（P = 0.010）和CgA强阳性（+++）（P = 0.007）是结直肠NETs患者5年PFS不良的独立危险因素。
直肠NETs的预后优于结肠神经内分泌肿瘤。肿瘤直径和肿瘤分级是结直肠神经内分泌肿瘤LNM的独立危险因素。年龄、肿瘤部位、淋巴结状态及神经内分泌标志物CgA的阳性水平是影响结直肠NETs预后的独立危险因素。
