Clinical Features and Long-Term Survival of Metastatic Hepatic Neuroendocrine Neoplasms Secondary to Gastroenteropancreatic Site: An Analysis by Applying the Grading Classification.

Method: Data of patients who were surgically treated and clinicopathologically diagnosed as (MH)-NENs secondary to (GEP)-NENs at West China Hospital of Sichuan University from January 2006 to December 2018 were retrospectively collected and analyzed by the grading classification for (GEP)-NENs.
Results: We identified 150 patients with (MH)-NENs secondary to (GEP)-NENs, including 10 patients with G1 NETs, 26 with G2 NETs, 33 with G3 NETs, and 81 with G3 NECs. There were significant differences between patients with G1/G2/G3 NETs and those with G3 NECs, such as age at diagnosis ( P =0.041), synchronous liver lesion ( P =0.032), incidental diagnosis ( P =0.014), tumor largest diameter ( P =0.047), vascular invasion ( P =0.017), and extrahepatic metastatic disease ( P =0.029). The estimated 3-year overall survival for patients with G1 NETs, G2 NETs, G3 NETs, and G3 NECs was 100%, 79.4%, 49.5%, and 20.7%, respectively ( P < 0.001). The survival of G1 NETs or G2 NETs was significantly better than that of G3 NETs ( P =0.013, P =0.037, respectively) and G3 NECs ( P =0.001, P < 0.001; respectively). Patients with G3 NECs present notably worse survival than those with G3 NETs ( P =0.012), while survival comparison between G1 NETs and G2 NETs was not statistically different ( P =0.131). The grading classification for (GEP)-NENs was an effective independent predictor of survival for (MH)-NENs secondary to (GEP)-NENs (hazard ratio: 4.234; 95% confidence intervals: 1.984-6.763; P =0.003).
Conclusion: Our demonstration revealed that the grading classification for (GEP)-NENs could well stratify (MH)-NENs secondary to (GEP)-NENs into prognostic groups and supported its wide use in clinical practice.
Competing Interests: The authors declare that they have no conflicts of interest and they did not have any sponsorship.
(Copyright © 2020 Min Yang et al.)