Clinical Research Papers:
Different longterm oncologic outcomes after radical surgical resection for neuroendocrine carcinoma and adenocarcinoma of the stomach
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Jian-Wei Xie1, Jun Lu1, Jian-Xian Lin1, Chao-Hui Zheng1, Ping Li1, Jia-Bin Wang1, Qi-Yue Chen1, Long-Long Cao1, Mi Lin1, Ru-Hong Tu1 and Chang-Ming Huang1
1 Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou, Fujian, People’s Republic of China
Correspondence to:
Chang-Ming Huang, email:
Keywords: gastric neoplasm, neuroendocrine neoplasm, prognosis, propensity score matching study
Received: June 20, 2016 Accepted: January 31, 2017 Published: February 18, 2017
Abstract
Purpose: To explore differences in long-term outcomes between gastric neuroendocrine carcinoma (GNEC) and gastric adenocarcinoma (GAC).
Methods: One hundred GNEC patients and 3089 GAC patients were enrolled. Differences in long-term outcomes between the groups were analyzed by 1:2 propensity score matching.
Results: Statistically significant differences between the groups were noted in terms of gender, American Society of Anesthesiologists score, tumor size, T stage, N stage, TNM stage and surgical approach. However, differences were not significant after matching. The 3-year and 5-year overall survival rates for the GNEC group were reduced compared with those for the GAC group, though disease-free survival rates and mean recurrence times were similar. Notably, the mean post-recurrence survival of the GNEC group was significantly worse than that of the GAC group (5.2 vs. 14.8 months, p<0.001). A strong negative correlation was found between a high Ki-67 labeling index and overall survival time. Cox regression analysis indicated the Ki-67 labeling index to be an independent factor influencing patient post-recurrence survival.
Conclusions: The long-term oncologic outcome of GNEC was worse than that of GAC, which may be relative to its reduced post-recurrence survival. A high Ki-67 labeling index was an independent factor influencing patient post-recurrence survival.