title: [Clinicopathological features and prognosis of patients with gastric neuroendocrine carcinoma from multiple centers in southern China].
abstract: OBJECTIVE
  To analyze the clinicopathological features and prognostic factors of gastric neuroendocrine carcinoma(NEC) based on a multicenter database from five medical centers in Southern China.
  
  
  METHODS
  Clinical and pathological data of 1 183 gastroenteropancreatic neuroendocrine neoplasms patients between January 2006 and December 2015 from five centers were retrospectively analyzed. A total of 156 gastric NEC cases(13.2%) with complete follow-up information were screened and included in the study, wherein 73 cases from Sun Yat-sen University Cancer Center, 27 cases from Nanfang Hospital of Southern Medical University, 26 cases from The First Affiliated Hospital of Sun Yat-sen University, 15 cases from Guangdong General Hospital and 15 cases from Sun Yat-sen Memorial Hospital of Sun Yat-sen University. The overall survival rate was calculated by using Kaplan-Meier method. The prognostic factor was analyzed using the Cox proportional hazards model.
  
  
  RESULTS
  In 156 NEC patients, the ratio of male to female was 3.9 vs 1.0, the median age was 61 years old, and the maximal tumor diameter was (4.5±2.3) cm. There were 12 case(7.7%) with functional tumors. At the initial diagnosis, there were 111 patients (71.2%) with regional lymph node metastases and 58 patients (37.2%) with distant metastases. One hundred and twenty-three patients (78.8%) underwent surgical treatment and 94 patients (60.3%) received systematic treatment. There were 31 patients(19.9%) in localized disease stage, 67 patients (42.9%) in regional disease stage and 58 patients(37.2%) in distant disease stage. The 5-year overall survival rate was 44.7%. Cox regression model showed that surgical treatment (HR=0.512, 95%CI:0.287 to 0.912, P=0.023) and clinical stage(HR=1.488, 95%CI:1.067 to 2.076, P=0.019) were independent prognostic factors. The 5-year overall survival rate of patients with and without surgical treatment were 54.6% and 10.9%(P=0.000). Meanwhile, the 5-year overall survival for localized, regional and distant disease stages were 66.1%, 56.1% and 21.1% respectively(P=0.000).
  
  
  CONCLUSIONS
  Gastric neuroendocrine carcinoma is a group of rare tumors with strong invasiveness, high malignancy and poor prognosis. The gastric NEC patients can benefit from surgical treatment.
authors.affiliation: Department of Gastric and Pancreatic Surgery, Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, Guangzhou 510064, China.
authors.forename: Cheng
authors.initials: C
authors.lastname: Fang
authors.affiliation: Department of Gastric and Pancreatic Surgery, Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, Guangzhou 510064, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Wang
authors.affiliation: Department of Gastroenterology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China.
authors.forename: Yu
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: Department of General Surgery, Guangdong General Hospital; Guangdong Acadamy of Medical Science, Guangzhou 510080, China.
authors.forename: Xingyu
authors.initials: X
authors.lastname: Feng
authors.affiliation: Department of Gastrointestinal Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510120, China.
authors.forename: Yujie
authors.initials: Y
authors.lastname: Zeng
authors.affiliation: Department of General Surgery, Guangdong General Hospital; Guangdong Acadamy of Medical Science, Guangzhou 510080, China. yuan821007@126.com.
authors.forename: Yong
authors.initials: Y
authors.lastname: Li
authors.affiliation: Department of Gastroenterology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China. chen0jie@hotmail.com.
authors.forename: Jie
authors.initials: J
authors.lastname: Chen
authors.affiliation: Department of Gastroenterology, Nanfang Hospital of Southern Medical University; Guangdong Provincial Key Laboratory of Gastroenterology, Guangzhou 510515, China. yechen@smu.edu.cn.
authors.forename: Ye
authors.initials: Y
authors.lastname: Chen
authors.affiliation: Department of Gastric and Pancreatic Surgery, Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, Guangzhou 510064, China. zhouzhw@sysucc.org.cn.
authors.forename: Zhiwei
authors.initials: Z
authors.lastname: Zhou
mesh_terms: D000328:Adult; D000368:Aged; D018278:Carcinoma, Neuroendocrine; D002681:China; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D018358:Neuroendocrine Tumors; D011379:Prognosis; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D013274:Stomach Neoplasms; D015996:Survival Rate