Comparison of overall survival of gastric neoplasms containing neuroendocrine carcinoma components with gastric adenocarcinoma: a propensity score matching study
Background
Gastric neoplasms containing neuroendocrine carcinoma (NEC) components are rare malignancies with highly aggressive behavior and a poor prognosis and include pure NEC and mixed tumors containing NEC components. We aimed to investigate whether there is a distinct difference in overall survival (OS) between gastric neoplasms containing NEC components and gastric adenocarcinoma.
Methods
Surgically resected gastric neoplasms containing NEC components (n=180) and gastric adenocarcinomas (n=785) from January 2013 to December 2019 at Peking University Cancer Hospital were retrospectively analysed. Patients were categorized into a surgical group and a neoadjuvant group and adjusted using propensity score matching. In the two groups, gastric neoplasms containing NEC components were divided into pure NEC and mixed tumors with less than 30% (<30% G-HMiNEN), between 30% and 70% (G-HMiNEN) and more than 70% (>70% G-HMiNEN) neuroendocrine carcinoma components. OS was compared between these groups and the gastric adenocarcinoma group.
Results
The OS of gastric neoplasms containing neuroendocrine NEC components was poorer than that of gastric adenocarcinomas in the surgical group, regardless of whether the percentage of neuroendocrine cancer components was less than 30%, between 30% and 70%, more than 70% or 100%. Cox multivariable regression analysis suggested that tumor category (neoplasms containing NEC components or gastric adenocarcinoma) was an independent risk factor for prognosis. Interestingly, among patients receiving neoadjuvant therapy, the difference was not significant.
Conclusions
Gastric neoplasms containing any proportion of NEC components had poorer overall survival than gastric adenocarcinoma in patients treated with surgery directly, indicating a higher degree of malignancy than gastric adenocarcinoma. Among the patients receiving neoadjuvant therapy, the difference in overall survival was not significant, which was in sharp contrast with the results of the surgery group, suggesting that neoadjuvant therapy may have a good effect in the treatment of these neoplasms.
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On 22 Jul, 2020
Received 20 Jul, 2020
Invitations sent on 14 Jul, 2020
On 14 Jul, 2020
On 09 Jul, 2020
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Received 09 Jun, 2020
Received 25 May, 2020
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Invitations sent on 15 May, 2020
On 15 May, 2020
On 14 May, 2020
On 14 May, 2020
On 08 May, 2020
Comparison of overall survival of gastric neoplasms containing neuroendocrine carcinoma components with gastric adenocarcinoma: a propensity score matching study
On 18 Aug, 2020
On 07 Aug, 2020
On 07 Aug, 2020
On 05 Aug, 2020
On 27 Jul, 2020
On 26 Jul, 2020
On 26 Jul, 2020
Posted 10 Jul, 2020
On 22 Jul, 2020
Received 20 Jul, 2020
Invitations sent on 14 Jul, 2020
On 14 Jul, 2020
On 09 Jul, 2020
On 08 Jul, 2020
On 08 Jul, 2020
On 10 Jun, 2020
Received 09 Jun, 2020
Received 25 May, 2020
On 19 May, 2020
On 15 May, 2020
Invitations sent on 15 May, 2020
On 15 May, 2020
On 14 May, 2020
On 14 May, 2020
On 08 May, 2020
Background
Gastric neoplasms containing neuroendocrine carcinoma (NEC) components are rare malignancies with highly aggressive behavior and a poor prognosis and include pure NEC and mixed tumors containing NEC components. We aimed to investigate whether there is a distinct difference in overall survival (OS) between gastric neoplasms containing NEC components and gastric adenocarcinoma.
Methods
Surgically resected gastric neoplasms containing NEC components (n=180) and gastric adenocarcinomas (n=785) from January 2013 to December 2019 at Peking University Cancer Hospital were retrospectively analysed. Patients were categorized into a surgical group and a neoadjuvant group and adjusted using propensity score matching. In the two groups, gastric neoplasms containing NEC components were divided into pure NEC and mixed tumors with less than 30% (<30% G-HMiNEN), between 30% and 70% (G-HMiNEN) and more than 70% (>70% G-HMiNEN) neuroendocrine carcinoma components. OS was compared between these groups and the gastric adenocarcinoma group.
Results
The OS of gastric neoplasms containing neuroendocrine NEC components was poorer than that of gastric adenocarcinomas in the surgical group, regardless of whether the percentage of neuroendocrine cancer components was less than 30%, between 30% and 70%, more than 70% or 100%. Cox multivariable regression analysis suggested that tumor category (neoplasms containing NEC components or gastric adenocarcinoma) was an independent risk factor for prognosis. Interestingly, among patients receiving neoadjuvant therapy, the difference was not significant.
Conclusions
Gastric neoplasms containing any proportion of NEC components had poorer overall survival than gastric adenocarcinoma in patients treated with surgery directly, indicating a higher degree of malignancy than gastric adenocarcinoma. Among the patients receiving neoadjuvant therapy, the difference in overall survival was not significant, which was in sharp contrast with the results of the surgery group, suggesting that neoadjuvant therapy may have a good effect in the treatment of these neoplasms.
Figure 1
Figure 2
Figure 3
Figure 4
Figure 5