Clinical Features and Long-Term Survival of Metastatic Hepatic Neuroendocrine Neoplasms Secondary to Gastroenteropancreatic Site: An Analysis by Applying the Grading Classification
Table 1
Clinical features of (MH)-NENs secondary to (GEP)-NENs according to the grading classification for (P)-NENs or (GI)-NENsA.
Characteristics
NET G1 (N = 10)
NET G2 (N = 26)
NET G3 (N = 33)
NEC G3 (N = 81)
All (N = 150)
valueB
Sex, male, n (%)
6 (60.0%)
15 (57.7%)
19 (57.6%)
50 (61.7%)
90 (60.0%)
0.154
Age at diagnosis, years
Median (range)
49 (42–59)
53 (44–64)
55 (42–69)
59 (45–74)
56 (42–74)
0.041
Synchronous liver lesion
5 (50.0%)
15 (57.7%)
20 (60.6%)
56 (69.1%)
96 (64.0%)
0.032
Primary tumor site
Stomach
2 (20.0%)
5 (19.2%)
6 (18.2%)
17 (20.9%)
30 (20.0%)
0.166
Small intestine
1 (10.0%)
3 (11.5%)
4 (12.1%)
4 (4.9%)
12 (8.0%)
Large intestine
3 (30.0%)
8 (30.8%)
8 (24.2%)
25 (30.8%)
44 (29.3%)
Pancreas
4 (40.0%)
10 (38.5%)
15 (45.5%)
35 (43.4%)
64 (42.7%)
Nonfunctional tumor
6 (60.0%)
13 (50.0%)
18 (54.5%)
47 (58.0%)
84 (56.0%)
0.209
Incidental diagnosis
3 (30.0%)
6 (23.1%)
10 (30.3%)
29 (35.8%)
48 (32.0%)
0.014
Multifocal lesionsC
8 (80.0%)
17 (65.4%)
25 (75.7%)
60 (74.1%)
110 (73.3%)
0.512
Tumor diameterD
Median (range)
8 (2–9)
9 (2–15)
11 (3–17)
15 (4–24)
13 (2–24)
0.047
Tumor location
Left half liver
1 (10.0%)
4 (15.4%)
5 (15.1%)
7 (8.7%)
17 (11.3%)
0.634
Right half liver
3 (30.0%)
6 (23.1%)
9 (27.3%)
23 (28.4%)
41 (27.4%)
Both
6 (60.0%)
16 (61.5%)
19 (57.6%)
51 (62.9%)
92 (61.3%)
Estimated liver involvement
≤50%
3 (30.0%)
7 (26.9%)
8 (24.2%)
20 (24.7%)
40 (26.7%)
0.591
Surgical procedure
Resection
3 (30.0%)
10 (38.5%)
12 (36.4%)
32 (39.5%)
57 (38.0%)
0.093
Ablation
3 (30.0%)
6 (23.1%)
7 (21.1%)
14 (17.3%)
30 (20.0%)
Both
2 (20.0%)
6 (23.1%)
9 (27.3%)
24 (29.6%)
41 (27.3%)
OthersE
2 (20.0%)
4 (15.3%)
5 (15.2%)
11 (13.6%)
22 (14.7%)
Surgical margin
R0F
4 (40.0%)
11 (42.3%)
12 (36.4%)
30 (37.1%)
57 (38.0%)
0.135
Preoperative systemic therapy
6 (60.0%)
16 (61.6%)
22 (66.7%)
49 (60.5%)
93 (62.0%)
0.542
Postoperative systemic therapy
8 (80.0%)
20 (77.0%)
28 (84.8%)
72 (88.9%)
128 (85.3%)
0.436
Regional lymph node metastases
3 (30.0%)
10 (38.5%)
12 (36.4%)
32 (39.5%)
57 (38.0%)
0.401
Portal vein tumor thrombus
4 (40.0%)
12 (46.2%)
14 (42.4%)
35 (43.2%)
65 (43.3%)
0.803
Vascular invasion
1 (10.0%)
3 (11.5%)
5 (15.2%)
18 (22.2%)
27 (18.8%)
0.017
Extrahepatic metastatic disease
2 (20.0%)
5 (19.2%)
8 (24.2%)
27 (33.3%)
42 (28.0%)
0.029
Out of contact
1 (10.0%)
6 (23.1%)
8 (24.2%)
22 (27.2%)
37 (24.7%)
NA
Dead at follow-up
4 (44.4%)
11 (55.0%)
15 (60.0%)
42 (71.2%)
72 (63.7%)
NA
Estimated 3-year OS
100%
79.4%
49.5%
20.7%
45.6%
<0.001
MST, months
64.6
48.5
32.2
21.5
31.9
<0.001
AThese characteristics of (MH)-NENs secondary to (GEP)-NENs were mainly based on the preoperative imaging examinations, intraoperative surgical findings, and postoperative pathological analysis. BReferring to the comparison between those with NET G1/G2/G3 and those with NEC G3 wherever possible. CReferring to no less than 1 metastatic lesion in the liver. DReferring to the sum of the largest diameter of all visible hepatic lesions. EReferring to some uncommon procedures, such as alcohol injection and liver transplantation, etc. FReferring to radical resections with both grossly and microscopically negative surgical margins. (MH)-NENs: metastatic hepatic neuroendocrine neoplasms; (GEP)-NENs: Gastroenteropancreatic neuroendocrine neoplasms; WHO: World Health Organization; NET: neuroendocrine tumor; NEC: neuroendocrine carcinoma; Ggrading; TNM: tumor-node-metastasis; AJCC: American Joint Committee On Cancer; NAnot applicable; OS: overall survival; MST: median survival time.
