Abstract
Background: Mixed neuroendocrine–non-neuroendocrine neoplasms are a rare subtype of neuroendocrine neoplasm consisting of ≥30% each of neuroendocrine and non-neuroendocrine differentiation. Neuroendocrine carcinomas are poorly differentiated neuroendocrine tumors. The epidemiology and prognosis of colorectal mixed neuroendocrine–non-neuroendocrine neoplasms and neuroendocrine carcinomas are not clearly defined in the literature. We sought to examine the presentation, patterns of care, and outcomes of patients with mixed neuroendocrine–non-neuroendocrine neoplasms and neuroendocrine carcinomas. Methods: We identified patients diagnosed with stage I–III colorectal (excluding appendix) mixed neuroendocrine–non-neuroendocrine neoplasms or neuroendocrine carcinomas with only one-lifetime cancer diagnosis who underwent surgical resection between 2010 and 2018 from the National Cancer Database. We performed bidirectional selection to identify variables to include in a multivariable Cox proportional hazards model. Results: We identified 189 patients with a diagnosis of stage I to III colorectal mixed neuroendocrine–non-neuroendocrine neoplasms, 66% of whom had poorly differentiated tumors and 482 with neuroendocrine carcinomas. Among patients with stage III disease, 68% of patients with mixed neuroendocrine–non-neuroendocrine neoplasms and 54% of patients with neuroendocrine carcinomas received adjuvant chemotherapy. The median survival for the overall patients with mixed neuroendocrine–non-neuroendocrine neoplasms and neuroendocrine carcinomas cohorts were 38 and 42 months, respectively (P = .22), and the median survival for patients with mixed neuroendocrine–non-neuroendocrine neoplasms and neuroendocrine carcinomas with stage III disease were 30 and 25 months, respectively (P = .27). In multivariable analysis, fewer number of positive nodes and receipt of adjuvant chemotherapy were independently associated with decreased risk of mortality for patients with mixed neuroendocrine–non-neuroendocrine neoplasms and neuroendocrine carcinomas. Conclusion: Adjuvant chemotherapy is associated with improved survival in stage III mixed neuroendocrine–non-neuroendocrine neoplasms and neuroendocrine carcinomas. Future studies are warranted to identify subsets of patients benefiting most from adjuvant therapy.
Original language | English (US) |
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Pages (from-to) | 735-742 |
Number of pages | 8 |
Journal | Surgery (United States) |
Volume | 175 |
Issue number | 3 |
DOIs | |
State | Published - Mar 2024 |
Bibliographical note
Publisher Copyright:© 2023 Elsevier Inc.
PubMed: MeSH publication types
- Journal Article