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Primary Neuroendocrine Tumors of the Endometrium: Management and Outcomes

OBJECTIVE: To analyze clinical behavior of, optimal treatment regimens for, outcomes, and prognosis of 170 patients with neuroendocrine tumors (NETs) of the endometrium. METHODS: The Surveillance, Epidemiology, and End Results database was used to identify patients with endometrial NETs diagnosed be...

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Autores principales: Zhang, Jingjing, Pang, Li
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9260008/
https://www.ncbi.nlm.nih.gov/pubmed/35814474
http://dx.doi.org/10.3389/fonc.2022.921615
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author Zhang, Jingjing
Pang, Li
author_facet Zhang, Jingjing
Pang, Li
author_sort Zhang, Jingjing
collection PubMed
description OBJECTIVE: To analyze clinical behavior of, optimal treatment regimens for, outcomes, and prognosis of 170 patients with neuroendocrine tumors (NETs) of the endometrium. METHODS: The Surveillance, Epidemiology, and End Results database was used to identify patients with endometrial NETs diagnosed between 2004 and 2015. Clinical features and treatment regimens were analyzed, and 5-year overall survival (OS) and cancer-specific survival (CSS) were compared among different stages and treatment regimens. Univariate and multivariate analyses were performed to identify independent prognostic factors associated with endometrial NETs. Finally, prognosis was compared between small- and large-cell neuroendocrine carcinoma (SCNEC and LCNEC, respectively) of the endometrium. RESULTS: There were 20, 8, 47, and 95 patients with stage I, II, III, and IV NET, respectively. The 5-year OS rates of patients in each stage were 59.86%, 42.86%, 32.75%, and 6.04%, respectively. The 5-year CSS survival rates were 59.86%, 50.0%, 38.33%, and 6.39%, respectively. In the multivariate analysis, American Joint Committee on Cancer (AJCC) stage and treatment were associated with poor OS, while AJCC stage, nodal metastasis, and treatment were associated with poor CSS. Neither pathological type nor distant metastasis was associated with prognosis. The rate of distant metastasis was significantly higher for LCNEC than for SCNEC, while 5-year OS and CSS rates were significantly lower. CONCLUSION: Complete surgical treatment should be selected regardless of staging for patients with endometrial NETs. For early-stage disease, individualized postoperative treatment with single chemotherapy or radiotherapy may improve OS and CSS. For advanced-stage disease, comprehensive postoperative adjuvant therapy may improve OS and CSS.
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spelling pubmed-92600082022-07-08 Primary Neuroendocrine Tumors of the Endometrium: Management and Outcomes Zhang, Jingjing Pang, Li Front Oncol Oncology OBJECTIVE: To analyze clinical behavior of, optimal treatment regimens for, outcomes, and prognosis of 170 patients with neuroendocrine tumors (NETs) of the endometrium. METHODS: The Surveillance, Epidemiology, and End Results database was used to identify patients with endometrial NETs diagnosed between 2004 and 2015. Clinical features and treatment regimens were analyzed, and 5-year overall survival (OS) and cancer-specific survival (CSS) were compared among different stages and treatment regimens. Univariate and multivariate analyses were performed to identify independent prognostic factors associated with endometrial NETs. Finally, prognosis was compared between small- and large-cell neuroendocrine carcinoma (SCNEC and LCNEC, respectively) of the endometrium. RESULTS: There were 20, 8, 47, and 95 patients with stage I, II, III, and IV NET, respectively. The 5-year OS rates of patients in each stage were 59.86%, 42.86%, 32.75%, and 6.04%, respectively. The 5-year CSS survival rates were 59.86%, 50.0%, 38.33%, and 6.39%, respectively. In the multivariate analysis, American Joint Committee on Cancer (AJCC) stage and treatment were associated with poor OS, while AJCC stage, nodal metastasis, and treatment were associated with poor CSS. Neither pathological type nor distant metastasis was associated with prognosis. The rate of distant metastasis was significantly higher for LCNEC than for SCNEC, while 5-year OS and CSS rates were significantly lower. CONCLUSION: Complete surgical treatment should be selected regardless of staging for patients with endometrial NETs. For early-stage disease, individualized postoperative treatment with single chemotherapy or radiotherapy may improve OS and CSS. For advanced-stage disease, comprehensive postoperative adjuvant therapy may improve OS and CSS. Frontiers Media S.A. 2022-06-23 /pmc/articles/PMC9260008/ /pubmed/35814474 http://dx.doi.org/10.3389/fonc.2022.921615 Text en Copyright © 2022 Zhang and Pang https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Oncology
Zhang, Jingjing
Pang, Li
Primary Neuroendocrine Tumors of the Endometrium: Management and Outcomes
title Primary Neuroendocrine Tumors of the Endometrium: Management and Outcomes
title_full Primary Neuroendocrine Tumors of the Endometrium: Management and Outcomes
title_fullStr Primary Neuroendocrine Tumors of the Endometrium: Management and Outcomes
title_full_unstemmed Primary Neuroendocrine Tumors of the Endometrium: Management and Outcomes
title_short Primary Neuroendocrine Tumors of the Endometrium: Management and Outcomes
title_sort primary neuroendocrine tumors of the endometrium: management and outcomes
topic Oncology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9260008/
https://www.ncbi.nlm.nih.gov/pubmed/35814474
http://dx.doi.org/10.3389/fonc.2022.921615
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