结直肠和小肠神经内分泌肿瘤患者的生存情况。

Survival in patients with neuroendocrine tumors of the colon, rectum and small intestine.

机构信息

Department of Surgery, Guthrie Robert Packer Hospital, Sayre, PA, 18840, USA.

出版信息

Am J Surg. 2023 Jan;225(1):58-65. doi: 10.1016/j.amjsurg.2022.09.053. Epub 2022 Oct 1.

DOI:10.1016/j.amjsurg.2022.09.053

PMID:36216612

Abstract

BACKGROUND

Neuroendocrine neoplasms (NENs) of the colon, rectum and small intestine (SI) are increasing in incidence and prevalence. We evaluated the 5-year overall survival (OS), and cancer-specific survival (CSS).

METHODS

The Surveillance, Epidemiology, and End Results (SEER) 18 registry from 2000 to 2017 was accessed to identify patients with colonic, rectal, and SI NENs.

RESULTS

46,665 patients were diagnosed with NENs of the colon (n = 10,518, 22.5%), rectum (18,063, 38.7%), and SI (18,084, 38.8%). By tumor site alone, patients with well-differentiated neuroendocrine tumors (NETs) of the rectum had improved 5-year OS (HR 0.72, 95% CI 0.68-0.77, p < 0.001). However, patients with rectal poorly-differentiated neuroendocrine carcinomas (NECs) who underwent oncologic resection had lower 5-year OS (35.1%) compared to colon (41.9%), and SI (72.5%).

CONCLUSIONS

Surgical resection may improve 5-year OS for NECs of the SI and colon, except in the rectum where survival was reduced. More frequent surveillance and timely initiation of systemic therapy should be considered for rectal NECs.

摘要

背景

结肠、直肠和小肠（SI）的神经内分泌肿瘤（NENs）的发病率和患病率正在增加。我们评估了 5 年的总生存率（OS）和癌症特异性生存率（CSS）。

方法

我们访问了 2000 年至 2017 年的监测、流行病学和最终结果（SEER）18 登记处，以确定患有结肠、直肠和 SI NENs 的患者。

结果

46665 例患者被诊断患有结肠（n=10518，22.5%）、直肠（18063，38.7%）和 SI（18084，38.8%）的 NENs。仅通过肿瘤部位，直肠分化良好的神经内分泌肿瘤（NETs）患者的 5 年 OS 得到改善（HR 0.72，95%CI 0.68-0.77，p<0.001）。然而，接受肿瘤切除治疗的直肠低分化神经内分泌癌（NECs）患者的 5 年 OS （35.1%）低于结肠（41.9%）和 SI（72.5%）。