Clinicopathological features and prognosis of patients with gastric neuroendocrine tumors: A population‐based study

Abstract

Abstract Background Despite its rarity, studies have shown the incidence of gastric neuroendocrine tumors (G‐NETs) is increasing. This study investigated the risk factors affecting the survival of G‐NETs patients and their prognosis over time. Method A retrospective analysis of 506 G‐NETs patients who underwent surgery for nonmetastatic disease from the Surveillance, Epidemiology and End Result database from 1988 to 2011 was conducted. Multivariate Cox regression analyses identified the prognostic factors affecting overall survival (OS) and disease‐specific survival (DSS). Three‐year conditional survival (COS3 and CDS3) estimates at “x” year after treatment were calculated as follows: COS3 = OS(x + 3)/OS(x) and CDS3 = DSS(x + 3)/DSS(x). Results The 1‐, 3‐, and 5‐year OS rates of all patients after surgery were 90.2%, 77.3%, and 68.8%, respectively. The 1‐, 3‐, and 5‐year DSS rates after surgery were 93.9%, 84.5%, and 80.9%, respectively. In the multivariate analysis, age, tumor grade, and T stage were independent prognostic factors of OS and DSS (all P < 0.05). With 1‐, 3‐, and 5‐year survivorship, the COS3 improved by +5.2 (82.2%), +7.2 (84.4%), and +8.5 (85.5%), respectively, and the CDS3 improved by +4.4 (89.4%), +9.1 (94.1%), and +12.5 (97.5%), respectively. Notably, the CDS3 improved dramatically among patients with advanced stage disease (eg, N0 stage: 93.0%‐98.9%, Δ5.9% vs N1 stage: 52.0%‐95.7%, Δ43.7%). Conclusion For G‐NETs patients, age, tumor grade, T stage, and N stage were the clinicopathological factors significantly associated with prognosis. There were excellent outcomes for most G‐NETs patients, with a CDS3 of greater than 90% across all independent prognostic factors after 5 years of survival.

Keywords

• conditional survival
• dynamics
• gastric neuroendocrine tumor
• prognosis