Clinicopathological and prognostic analyses of colonic neuroendocrine neoplasms
Objective To explore the clinicopathological features of colonic neuroendocrine neoplasms(CNENs)and identify prognostic factors.Methods Clinical data were retrospectively reviewed for 28 patients hospitalized with CNENs from January 2012 to December 2022.The differences were examined in clinical characteristics of CNENs between left and right colon.Survival analysis was performed with Kaplan-Meier curve and clinical factors affecting the prognosis of CNENs summarized.Results There were 18 males and 10 females with a median age of 57.0(52.0-64.0)years.Tumor diameter was<2 cm(n=5)and≥2 cm(n=23).Tumor was located in right colon(n=28)and left colon(n=9).Compared with CNENs in left colon,those located in right colon had larger tumor diameters and advanced T stages(P<0.05).There were endoscopic mucosal resection(n=2),endoscopic submucosal dissection with additional local resection(n=1),endoscopic submucosal dissection with additional radical resection(n=1),radical resection(n=12),palliative resection(n=7)and non-surgery(n=5).The clinical stages were T1(n=6),T3(n=5)and T4(n=17).Among 20 cases of radical/palliative resection plus lymphadenectomy,15 were pathologically confirmed as associated lymph node metastasis and 10 had associated distant metastases.During a median period of 34.5(3.0-118.0)month,11 patients died from disease progression.Seven cases of colonic neuroendocrine tumors(CNETs)without distant metastasis achieved long-term survival after primary tumor resection.Univariate prognostic analysis revealed that tumor diameter,pathological classification,depth of invasion and M stage were associated with cancer-specific survival(CSS)(all P<0.05).And multivariate analysis indicated that M stage was significantly associated with prognosis[HR=8.958,95%CI(2.241,35.811),P=0.002].Conclusion CNENs have a high rate of metastasis and an overall poor prognosis.For CNETs without distant metastasis,primary tumor resection is efficacious.
万方数据
维普
