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. 2022 Jun 29;22(1):253.
doi: 10.1186/s12893-022-01689-7.

The clinical and prognostic factors for biliary neuroendocrine neoplasm: a study based on the SEER database

Bo-Hao Zheng #  1   2   3   4   5 , Cheng Zhang #  1   2   3   4   5 , Wen-Ze Wan #  1   2   3   4   5 , Wen-Tao Sun  1   2   3   4   5 , Xi Cheng  1   2   3   4   5 , Xiao-Jian Ni  1   2   3   4   5 , Xiao-Ling Ni  1   2   3   4   5 , Tao Suo  1   2   3   4   5 , Han Liu  1   2   3   4   5 , Sheng Shen  6   7   8   9   10 , Hou-Bao Liu  11   12   13   14   15   16
Affiliations

The clinical and prognostic factors for biliary neuroendocrine neoplasm: a study based on the SEER database

Bo-Hao Zheng et al. BMC Surg. .

Abstract

Background: In this study, we aimed at elucidating the postoperative survival and prognostic factors in patients with biliary neuroendocrine neoplasm (NEN).

Methods: Cases of biliary system NEN and adenocarcinoma from 1975 to 2016 were extracted from the Surveillance, Epidemiology, and End Results (SEER) database. A propensity score matching (PSM) method was used to adjust baseline differences in clinicopathological characteristics in our analysis. The Kaplan-Meier analysis was carried out for survival analysis.

Results: A total of 233 patients with biliary system NEN were enrolled in this study, of which 119 patients' lesions located in gallbladder, while the others' located in bile duct. The postoperative overall survival of bile duct NEN is significantly longer than that of gallbladder NEN (P < 0.001). For gallbladder NENs, surgery method (P = 0.020) and lymph node metastasis (P = 0.018) were identified as independent prognostic factors. In terms of ampulla of vater (AOV) NENs, age (P = 0.017) and lymph node metastasis (P = 0.006) were identified as independent prognostic factors, while grade (P = 0.002) and lymph node metastasis (P = 0.036) were identified as independent prognostic factors for extrahepatic bile duct (EBD) NENs. PSM analysis indicated that patients with biliary duct NENs have a better postoperative prognosis than biliary duct adenocarcinoma.

Conclusions: Patients with NEN have better overall survival than patients with adenocarcinoma. Gallbladder NEN has an adverse prognosis than that of biliary tract NEN. The pathological subtype, differentiation, lymph node metastasis, surgery method, and lymph node resection could affect the postoperative prognosis of the gallbladder and biliary tract NEN.

Keywords: Biliary tract; Gallbladder; Neuroendocrine neoplasm; Prognosis; Propensity-matching analysis.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
The overview of the bile system NENs from 1986 to 2016. A From 1986 to 2016, the incidence of bile system NEN is rising. B From 1986 to 2016, a total of 233 NEN patients received surgery. Among them, 119 patients (51.07%) patients were gallbladder NENs, 82 patients were AOV NENs, and 32 patients were EBD NENs. C The postoperative overall survival of biliary tract neuroendocrine neoplasm has better overall survival than that of the gallbladder neuroendocrine neoplasm (Log-rank test, P < 0.0001), while no significant differences were observed between the AOV NENs and EBD NENs in overall survival
Fig. 2
Fig. 2
The postoperative prognosis factors for the gallbladder NENs. A Patients with higher differentiation levels (I + II) has better postoperative overall survival than those of the patients with lower differentiation levels (III+IV) (Log-rank test, P < 0.001). B The postoperative survival of NET was better than that of NEC and MiNENs (Log-rank test, P < 0.0001). C Patients receiving radical surgery have worse overall survival than patients receiving the local regional resection (Log-rank test, P = 0.006). D Patients with lymph node metastasis have worse postoperative overall survival than those of patients without lymph node metastasis (Log-rank test, P = 0.014)
Fig. 3
Fig. 3
The postoperative prognosis factors for the AOV NENs. A The postoperative overall survival of patients with higher differentiation levels (I + II) has better overall survival than that of the patients with lower differentiation levels (III+IV) (Log-rank test, P < 0.001). B The postoperative survival of NET was better than that of NEC and MiNENs (Log-rank test, P < 0.0001). C Patients receiving radical surgery have worse overall survival than patients receiving the local regional resection (Log-rank test, P = 0.03). D Patients with lymph node metastasis have worse postoperative overall survival than those of patients without lymph node metastasis (Log-rank test, P = 0.048)
Fig. 4
Fig. 4
The postoperative prognostic factor for the EBD NENs. A The postoperative overall survival of patients with higher differentiation levels (I + II) was better than that of the patients with lower differentiation levels (III+IV) (Log-rank test, P < 0.001). B The postoperative survival of NET was better than that of NEC and MiNENs (Log-rank test, P < 0.0001). C Patients receiving radical surgery have worse overall survival than patients receiving the local regional resection (Log-rank test, P = 0.03). D Patients with lymph node metastasis have worse postoperative overall survival than those of patients without lymph node metastasis (Log-rank test, P = 0.211)
Fig. 5
Fig. 5
PSM analysis indicated that biliary system neuroendocrine neoplasm (NEN) has better survival than that of biliary system adenocarcinoma (AD)
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