Skip to main content
SpringerLink
Log in

Management and Survival Analysis of Gastrointestinal Neuroendocrine Tumors by Different Tumor Characteristics: Tertiary Center Experience

  • Original Research
  • Published:
Journal of Gastrointestinal Cancer Aims and scope Submit manuscript

Abstract

Background

Gastrointestinal neuroendocrine tumor (GI-NET) is a group of neoplasia consisting of amine and acid producing cells with different hormonal profiles. Although the entire GIS accounts for about 2% of tumors, recent research reveals that the incidence rate has increased. Given the increasing incidence in GI-NETs, more and more extensive research is needed on this subject. In this regard, the demographic and clinicopathological features of the patients diagnosed with GI-NET and their relationship with survival were investigated in the present study.

Methods

Thirty-four patients diagnosed with GI-NETs between January 2009 and December 2019 at the Department of Gastroenterology, Inonu University Faculty of Medicine were analyzed retrospectively. Gender, age, tumor localization, metastasis status, tumor number, tumor diameter, tumor grade, Ki-67 index, and the relationships of these factors with overall survival were examined.

Results

Of the patients, 61.8% included in the study were male and 38.2% were female. The average age of the patients was 60.74 years. The most common tumor location was in the stomach (26.5%) and liver (26.5%). Apart from this, 17.6% of NETs were seen in the pancreas, 11.8% in the colon, 8.8% in the rectum, 5.9% in the small intestine, and 2.9% in the appendix. No significant relationship was observed between tumor location and gender (p = .326) and age (p = .641). The tumor diameter ranged from 0.2 cm to 13.91 cm, but the average tumor diameter was 3.84 cm. Solitary tumor was found in 51.5% of cases and multiple tumors in 48.5% of cases. The most common grade was Grade 1 with 41.2% of occurrence. The average of Ki-67 index was 18.36%. There was metastasis in 52.9% of cases. The rate of medical treatment was 48.5%. The median overall survival time of the patients was 23.1 months. In addition, 1-year overall survival was 74.9%, 2-year overall survival was 44.6%, and 5-year overall survival was 35.7%. A statistically significant difference was found between tumor grade and the presence of metastasis, and the overall survival (p = .003 and p = .005).

Conclusions

The tumor grade and the presence of metastasis in gastrointestinal neuroendocrine tumors were found to be the most important prognostic factors affecting overall survival.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Plöckinger U, Rindi G, Arnold R, Eriksson B, Krenning EP, de Herder WW, Goede A, Caplin M, Oberg K, Reubi JC, Nilsson O, Delle Fave G, Ruszniewski P, Ahlman H, Wiedenmann B. European Neuroendocrine Tumour Society. Guidelines for the diagnosis and treatment of neuroendocrine gastrointestinal tumours. A consensus statement on behalf of the European Neuroendocrine Tumour Society (ENETS). Neuroendocrinology. 2004;80:394–424. https://doi.org/10.1159/000085237.

    Article  CAS  Google Scholar 

  2. Tsikitis VL, Wertheim BC, Guerrero MA. Trends of incidence and survival of gastrointestinal neuroendocrine tumors in the United States: a seer analysis. J Cancer. 2012;3:292–302. https://doi.org/10.7150/jca.4502.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Huguet I, Grossman AB, O’Toole D. Changes in the epidemiology of neuroendocrine tumours. Neuroendocrinology. 2017;104:105–11. https://doi.org/10.1159/000441897.

    Article  CAS  PubMed  Google Scholar 

  4. Dasari A, Shen C, Halperin D, Zhao B, Zhou S, Xu Y, Shih T, Yao JC. Trends in the incidence, prevalence, and survival outcomes in patients with neuroendocrine tumors in the United States. JAMA Oncol. 2017;3:1335–42. https://doi.org/10.1001/jamaoncol.2017.0589.

    Article  PubMed  PubMed Central  Google Scholar 

  5. Hauso O, Gustafsson BI, Kidd M, Waldum HL, Drozdov I, Chan AK, Modlin IM. Neuroendocrine tumor epidemiology: contrasting Norway and North America. Cancer. 2008;113:2655–64. https://doi.org/10.1002/cncr.23883.

    Article  PubMed  Google Scholar 

  6. Rothenstein J, Cleary SP, Pond GR, Dale D, Gallinger S, Moore MJ, Brierley J, Siu LL. Neuroendocrine tumors of the gastrointestinal tract: a decade of experience at the Princess Margaret Hospital. Am J Clin Oncol. 2008;31:64–70. https://doi.org/10.1097/COC.0b013e31807a2f49.

    Article  PubMed  Google Scholar 

  7. Caldarella A, Crocetti E, Paci E. Distribution, incidence, and prognosis in neuroendocrine tumors: a population based study from a cancer registry. Pathol Oncol Res. 2011;17:759–63. https://doi.org/10.1007/s12253-011-9382-y.

    Article  CAS  PubMed  Google Scholar 

  8. Ito T, Igarashi H, Nakamura K, Sasano H, Okusaka T, Takano K, Komoto I, Tanaka M, Imamura M, Jensen RT, Takayanagi R, Shimatsu A. Epidemiological trends of pancreatic and gastrointestinal neuroendocrine tumors in Japan: a nationwide survey analysis. J Gastroenterol. 2015;50:58–64. https://doi.org/10.1007/s00535-014-0934-2.

    Article  PubMed  Google Scholar 

  9. Lepage C, Ciccolallo L, De Angelis R, Bouvier AM, Faivre J, Gatta G, EUROCARE Working Group. European disparities in malignant digestive endocrine tumours survival. Int J Cancer. 2010;126:2928–34. https://doi.org/10.1002/ijc.24698.

    Article  CAS  PubMed  Google Scholar 

  10. Anderson LA, Tavilla A, Brenner H, Luttmann S, Navarro C, Gavin AT, Holleczek B, Johnston BT, Cook MB, Bannon F, Sant M. EUROCARE-5 Working Group. Survival for oesophageal, stomach and small intestine cancers in Europe 1999–2007: results from EUROCARE-5. Eur J Cancer. 2015;51:2144–57. https://doi.org/10.1016/j.ejca.2015.07.026.

    Article  Google Scholar 

  11. Tsai HJ, Wu CC, Tsai CR, Lin SF, Chen LT, Chang JS. The epidemiology of neuroendocrine tumors in Taiwan: a nation-wide cancer registry-based study. PLoS One. 2013;8: e62487. https://doi.org/10.1371/journal.pone.0062487.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  12. Yao JC, Hassan M, Phan A, Dagohoy C, Leary C, Mares JE, Abdalla EK, Fleming JB, Vauthey JN, Rashid A, Evans DB. One hundred years after “carcinoid”: epidemiology of and prognostic factors for neuroendocrine tumors in 35,825 cases in the United States. J Clin Oncol. 2008;26:3063–72. https://doi.org/10.1200/JCO.2007.15.4377.

    Article  PubMed  Google Scholar 

  13. Modlin IM, Lye KD, Kidd M. A 5-decade analysis of 13,715 carcinoid tumors. Cancer. 2003;97:934–59. https://doi.org/10.1002/cncr.11105.

    Article  PubMed  Google Scholar 

  14. Maggard MA, O’Connell JB, Ko CY. Updated population-based review of carcinoid tumors. Ann Surg. 2004;240:117–22. https://doi.org/10.1097/01.sla.0000129342.67174.67.

    Article  PubMed  PubMed Central  Google Scholar 

  15. Ellis L, Shale MJ, Coleman MP. Carcinoid tumors of the gastrointestinal tract: trends in incidence in England since 1971. Am J Gastroenterol. 2010;105:2563–9. https://doi.org/10.1038/ajg.2010.341.

    Article  PubMed  Google Scholar 

  16. Kim SJ, Kim JW, Han SW, Oh DY, Lee SH, Kim DW, Im SA, Kim TY, Seog Heo D. Bang YJ. Biological characteristics and treatment outcomes of metastatic or recurrent neuroendocrine tumors: tumor grade and metastatic site are important for treatment strategy. BMC Cancer. 2010;10:448. https://doi.org/10.1186/1471-2407-10-448.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  17. Foltyn W, Zajęcki W, Marek B, Kajdaniuk D, Siemińska L, Zemczak A, Kos-Kudła B. The value of the Ki-67 proliferation marker as a prognostic factor in gastroenteropancreatic neuroendocrine tumours. Endokrynol Pol. 2012;63:362–6.

    CAS  PubMed  Google Scholar 

  18. Kim SJ, Kim JW, Oh DY, Han SW, Lee SH, Kim DW, Im SA, Kim TY, Heo DS, Bang YJ. Clinical course of neuroendocrine tumors with different origins (the pancreas, gastrointestinal tract, and lung). Am J Clin Oncol. 2012;35:549–56. https://doi.org/10.1097/COC.0b013e31821dee0f.

    Article  PubMed  Google Scholar 

  19. Yucel B, Babacan NA, Kacan T, Eren AA, Eren MF, Bahar S, Celasun MG, Seker MM, Hasbek Z. Survival analysis and prognostic factors for neuroendocrine tumors in Turkey. Asian Pac J Cancer Prev. 2014;14:6687–92. https://doi.org/10.7314/apjcp.2013.14.11.6687.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Internal Medicine, Faculty of Medicine, Inonu University, Malatya, 44280, Turkey

    Bedia Gonulal

  2. Department of Gastroenterology, Faculty of Medicine, Inonu University, Malatya, 44280, Turkey

    Yilmaz Bilgic

  3. Department of Surgery, Faculty of Medicine, Inonu University, Malatya, 44280, Turkey

    Sami Akbulut & Ertugrul Karabulut

  4. Department of Pathology, Faculty of Medicine, Inonu University, Malatya, 44280, Turkey

    Emine Turkmen Samdanci

Authors
  1. Bedia Gonulal
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Yilmaz Bilgic
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Sami Akbulut
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Ertugrul Karabulut
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Emine Turkmen Samdanci
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Yilmaz Bilgic.

Ethics declarations

Conflict of Interest

The authors declare no competing interests.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Gonulal, B., Bilgic, Y., Akbulut, S. et al. Management and Survival Analysis of Gastrointestinal Neuroendocrine Tumors by Different Tumor Characteristics: Tertiary Center Experience. J Gastrointest Canc 53, 915–920 (2022). https://doi.org/10.1007/s12029-021-00709-8

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12029-021-00709-8

Keywords

Search

Navigation