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Comparison of overall survival of gastric neoplasms containing neuroendocrine carcinoma components with gastric adenocarcinoma: a propensity score matching study
Jiafu Ji
Peking University Cancer Hospital & Institute
Corresponding Author
ORCiD: https://orcid.org/0000-0002-4235-4507
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published version at BMC Cancer.
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.
Keywords
Neuroendocrine Carcinoma, Gastric Adenocarcinoma, Overall Survival
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On 07 Aug, 2020
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On 07 Aug, 2020
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Editorial decision: Minor revision
On 05 Aug, 2020
Editor assigned
On 27 Jul, 2020
Submission checks complete
On 26 Jul, 2020
Editor invited
On 26 Jul, 2020
Version 2
Posted 10 Jul, 2020
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Editorial decision: Minor revision
On 22 Jul, 2020
Review #1 received
Received 20 Jul, 2020
Reviewers invited
Invitations sent on 14 Jul, 2020
Reviewer #1 agreed
On 14 Jul, 2020
Editor assigned
On 09 Jul, 2020
Submission checks complete
On 08 Jul, 2020
Editor invited
On 08 Jul, 2020
No comments provided
Editorial decision: Major revision
On 10 Jun, 2020
Review #2 received
Received 09 Jun, 2020
Review #1 received
Received 25 May, 2020
Reviewer #2 agreed
On 19 May, 2020
Editor assigned
On 15 May, 2020
Reviewers invited
Invitations sent on 15 May, 2020
Reviewer #1 agreed
On 15 May, 2020
Submission checks complete
On 14 May, 2020
Editor invited
On 14 May, 2020
First submitted
On 08 May, 2020
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This preprint is under consideration at BMC Cancer. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Comparison of overall survival of gastric neoplasms containing neuroendocrine carcinoma components with gastric adenocarcinoma: a propensity score matching study
Jiafu Ji
Peking University Cancer Hospital & Institute
Corresponding Author
ORCiD: https://orcid.org/0000-0002-4235-4507
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
Published
On 18 Aug, 2020
No community comments so far
Submission checks complete
On 07 Aug, 2020
Editorial decision: Accept
On 07 Aug, 2020
No comments provided
Editorial decision: Minor revision
On 05 Aug, 2020
Editor assigned
On 27 Jul, 2020
Submission checks complete
On 26 Jul, 2020
Editor invited
On 26 Jul, 2020
Version 2
Posted 10 Jul, 2020
No comments provided
Editorial decision: Minor revision
On 22 Jul, 2020
Review #1 received
Received 20 Jul, 2020
Reviewers invited
Invitations sent on 14 Jul, 2020
Reviewer #1 agreed
On 14 Jul, 2020
Editor assigned
On 09 Jul, 2020
Submission checks complete
On 08 Jul, 2020
Editor invited
On 08 Jul, 2020
No comments provided
Editorial decision: Major revision
On 10 Jun, 2020
Review #2 received
Received 09 Jun, 2020
Review #1 received
Received 25 May, 2020
Reviewer #2 agreed
On 19 May, 2020
Editor assigned
On 15 May, 2020
Reviewers invited
Invitations sent on 15 May, 2020
Reviewer #1 agreed
On 15 May, 2020
Submission checks complete
On 14 May, 2020
Editor invited
On 14 May, 2020
First submitted
On 08 May, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published version at BMC Cancer.
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