Clinical analysis of 547 patients with neuroendocrine tumors in a Chinese population: A single-center study

Abstract

Background: Neuroendocrine tumors (NETs) are rare, which has resulted in a lack of published data on their epidemiology and clinical features. We therefore aimed to investigate the epidemiology, clinical features, treatments, and prognosis of patients with NETs.

Methods: The clinicopathologic characteristics of 547 patients who were pathologically diagnosed with NETs were retrospectively analyzed, including age, sex, primary and metastatic sites, symptoms, pathology, treatment, and prognosis.

Results: The 547 patients had a wide age range (9-87 years), with a male to female ratio of 1:1.1. The primary tumor sites included 413 in the digestive system, 74 in the lung, 15 in the mediastinum, 8 in unknown sites, and 37 in other sites. Of the 413 patients with digestive system NETs, the pancreas, rectum, and stomach were the most common primary sites. Blood metastases were found in 84 patients at initial diagnosis, and the liver, bone, and lung were the most frequent sites of metastasis. Lymph node metastases were found in 82 patients at initial diagnosis. Surgery and chemotherapy were the most widely applied treatments. Statistical analysis showed that age <50 years, female sex, lower-grade tumor, no distant metastasis, intestinal NET and surgery indicated a favorable prognosis.

Conclusions: A difference between China and other countries is that small intestinal NETs are quite common in other countries but are rare in China. In China, the most common primary sites are the pancreas, rectum, and stomach. Furthermore, no unified treatments exist, though prognoses could be improved by using methods such as surgery, targeted therapies, and somatostatin analogs.

Clinical trial registration: This study was not a clinical trial.

Keywords: epidemiology; neuroendocrine tumors; pathology; prognosis; treatments.

Figure 1

Kaplan‐Meier analysis of overall survival. A, Overall survival stratified by sex of NET patients. B, Overall survival stratified by age of NET patients. C, Overall survival stratified by treatment approach used in NET patients. D, Overall survival stratified by stage of NET patients. E, Overall survival stratified by grade in pulmonary NET patients. F, Overall survival stratified by grade in GEP‐NET patients. G, Overall survival stratified by primary site in NET patients. GEP‐NETs, gastroenteropancreatic neuroendocrine tumors; NET, neuroendocrine tumor