Turkish Journal of Gastroenterology
Original Article

Best prognostic factor of neuroendocrine tumors: Grade or Stage? A multidisciplinary single-center study

1.

Department of Medical Oncology, Erciyes University School of Medicine, Kayseri, Turkey

2.

Department of Endocrinology, Erciyes University School of Medicine, Kayseri, Turkey

3.

Department of Gastroenterology, Erciyes University School of Medicine, Kayseri, Turkey

4.

Department of Pathology, Erciyes University School of Medicine, Kayseri, Turkey

5.

Department of Surgery, Erciyes University School of Medicine, Kayseri, Turkey

6.

Department of Nuclear Medicine, Erciyes University School of Medicine, Kayseri, Turkey

7.

Department of Radiology, Erciyes University School of Medicine, Kayseri, Turkey

8.

Department of Internal Medicine, Kayseri Training and Research Hospital, Kayseri, Turkey

Turk J Gastroenterol 2016; 27: 509-514
DOI: 10.5152/tjg.2016.16391
Read: 983 Downloads: 299 Published: 25 July 2019

Abstract

Background/Aims: Currently, there is no definite consensus about the prognostic factors of neuroendocrine tumors (NETs). We evaluate epidemiology, survival and especially prognostic factors in NETs.

 

Materials and Methods: Patients who had a NET and were diagnosed between 2000 and 2014 at a tertiary care center were included. Demographic data, tumor characteristics and survival rates were evaluated, retrospectively.

 

Results: Two-hundred and thirty-three patients (123 male, 110 female; median age, 55 years [16–92 years]) took part in the study. Primary NET sites were the lung (n=56), stomach (n=50), pancreas (n=39), colorectal (n=21), small intestine (n=19), and appendix (n=19). According to the NET classification by the WHO in 2010, 60% (n=140) of patients were grade-1, 15% (n=35) were grade-2, and 25% (n=58) were grade-3. According to TNM staging, 88 patients (37.8%) were stage I, 30 patients (12.8%) were stage II, 22 patients (9.5%) were stage III, and 93 patients (39.9%) were stage IV. Univariate analysis revealed significant associations between gender, age, grade, lymph node metastasis, distant metastasis, stage, and the number of organs impacted by metastases and overall survival. However, with multivariate analysis only age greater than 55 years, advancing grade, and inoperable tumors were significantly associated with shortened survival. Five-year survival was 81% in grade-1, 34% in grade-2, and 9% in grade-3 NETs.

 

Conclusion: This study is the most comprehensive study in Turkey that has evaluated NETs using a multidisciplinary approach. Also, we suggest that age, operability and especially grade rather than stage are the most important prognostic factors in NETs.

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