title: Gastroenteropancreatic Neuroendocrine Tumors with Liver Metastases in Korea: A Clinicopathological Analysis of 72 Cases in a Single Institute.
abstract: OBJECTIVE
  Management of gastroenteropancreatic (GEP) neuroendocrine tumors with liver metastases (NETLM) presents many clinical challenges. Assessment of the extent of disease and primary tumor site is crucial for management. In this study, we investigated the primary tumor sites and prognostic factors in GEP NETLM among Korean patients.
  
  
  METHODS
  We reviewed the medical records of 72 Korean patients diagnosed with GEP NETLM between January 1999 and May 2013, focusing on their clinical and pathologic characteristics.
  
  
  RESULTS
  The most frequently encountered primary tumor sites were the pancreas (n=25, 35%), stomach (n=8, 11%), gall bladder (n=4, 6%) and rectum (n=3, 4%). Twenty-five patients (35%) had occult primary tumor. Twelve patients (17%) had histological grade G1 tumors, 30 patients (42%) had G2 tumors, and 30 patients (42%) had G3 tumors. The mean follow-up period after histological confirmation of hepatic metastases was 11.30±2.44 months for G3 tumors, 19.67±4.09 months for G2 tumors, and 30.67±6.51 months for G1 tumors. Multivariate analyses revealed that an unknown primary tumor site (p=0.001) and higher histological grade (p < 0.001) were independent prognostic indicators for shorter overall survival (OS). Most long-term survivors (OS > 24 months) had received antitumor treatment.
  
  
  CONCLUSIONS
  The primary tumor site most frequently associated with GEP NETLM was the pancreas. Unknown primary tumor and higher histological grade were independent prognostic indicators for shorter OS. Patients identified as being at a risk of shorter OS should be followed up closely.
authors: Department of Pathology and Translational Genomics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors: Yooju
authors: Y
authors: Shin
authors: Department of Pathology and Translational Genomics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors: Sang Yun
authors: SY
authors: Ha
authors: Department of Pathology and Translational Genomics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors: Jiyeon
authors: J
authors: Hyeon
authors: Department of Pathology and Translational Genomics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors: Boram
authors: B
authors: Lee
authors: Division of Hemato-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors: Jeeyun
authors: J
authors: Lee
authors: Department of Pathology and Translational Genomics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors: Kee-Taek
authors: KT
authors: Jang
authors: Department of Pathology and Translational Genomics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors: Kyoung-Mee
authors: KM
authors: Kim
authors: Division of Hemato-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors: Young Suk
authors: YS
authors: Park
authors: Department of Pathology and Translational Genomics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors: Cheol-Keun
authors: CK
authors: Park
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007414:Intestinal Neoplasms / Q000188:drug therapy / Q000453:epidemiology* / Q000473:pathology* / Q000601:surgery; D008113:Liver Neoplasms / Q000453:epidemiology* / Q000556:secondary*; D008297:Male; D008875:Middle Aged; D018358:Neuroendocrine Tumors / Q000188:drug therapy / Q000453:epidemiology* / Q000473:pathology* / Q000601:surgery; D010190:Pancreatic Neoplasms / Q000188:drug therapy / Q000453:epidemiology* / Q000473:pathology* / Q000601:surgery; D056910:Republic of Korea / Q000453:epidemiology; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000188:drug therapy / Q000453:epidemiology* / Q000473:pathology* / Q000601:surgery; D016019:Survival Analysis; D055815:Young Adult
chemical_list: D000970:Antineoplastic Agents
keywords: Liver; Metastasis; Neuroendocrine tumor; Pathology; Prognosis