The Effect Of The Neuroendocrine Component On The Survival Of Gastric Carcinomas Characterized By Coexisting Exocrine And Neuroendocrine Components

Background:Gastric tumors with combinations of exocrine and neuroendocrine(NE)components,ranging from adenomas or carcinomas with interspersed NE cells at one extreme to classical NE tumors with a focal exocrine component at the other,are frequently observed in routine practice.Several previous studies have investigated the influence of the propotion of NE component on survival of these tumors,however,the results was inconsistent.Methods:We retrospectively investigated a consecutive series of 95 patients with gastric tumor with a combination of exocrine and NE components who underwent radical gastrectomy with D2 lymphadenectomy between February 2011 and January 2016 at the China National Cancer Center.We adopted 10%,20%,30%,50%and 70%of NE component as a cut-off,respectively,and analysed patient overall survival(OS)according to the proportion of NE component.Prognostic factors were examined using Cox proportional hazards models.The survival curves were analysed by the Kaplan-Meier method and the differences between the survival curves were estimated by a log-rank test.Results:The 1-,2-,3-,and 4-year actuarial survival rates of all 95 patients were 95.3%,83.8%,74.7%,70.5%,respectively.On multivariate analysis,the diameter of the tumor(≥4.7cm)(hazards ratio[HR],2.246;95%confidence interval[CI],1.721-2.785);the pN3(HR,5.159;95%CI,1.032-19.342)were significantly associated with worse OS.The difference in the proportion of NE component did not show a significant association with the survival.Conclusion:The difference in the proportion of NE component does not affect survival of gastric tumors characterized by coexisting exocrine and neuroendocrine components.Only diameter of the tumor and metastatic lymph node number were independent prognostic factors for these tumors.