Effect of surgical treatment on prognosis in patients with rectal small cell neuroendocrine carcinoma based on SEER database_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

HUANG Kun , HE Yunsheng , ZHAO Pan ,  ZHAO Pingwu

Department of General Surgery, Mianyang Traditional Chinese Medicine Hospital, Mianyang, Sichuan 621000, P. R. China;

Corresponding author：

ZHAO Pingwu, Email: zhaopingwu01@hotmail.com

Keywords：

rectal small cell neuroendocrine carcinoma; surgical treatment; prognosis; SEER database

DOI：

10.7507/1007-9424.202208041

Video：

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Objective To explore the value of surgical treatment in rectal small cell neuroendocrine carcinoma (RSCC). Method The clinical data of patients with pathologically diagnosed as RSCC from 2000 to 2019 were extracted from the Surveillance, Epidemiology and End Results (SEER) database, to explore the effect of surgical treatment on cancer-specific survival (CSS) and overall survival (OS). Results A total of 348 cases were included with the median follow-up of 8 months (IQR: 3–16 months). Of the 101 patients in the operation group, 84 died (83.2%), including 56 tumor-related deaths (55.4%). Of the 247 patients in the non-operation group, 215 died (87.0%), including 131 tumor-related deaths (53.0%). The estimated 1-year OS of the operation group and the non-operation group were 49.6% and 34.4%, respectively, and the estimated 1-year CSS of those were 62.2% and 49.2%, respectively. There were significant differences between the two groups (both P<0.05). Results of multivariate prognostic analysis by Cox proportional hazard model showed that differentiation, SEER stage, receiving operative treatment or not, receiving chemotherapy or not, and receiving radiotherapy or not were independent influencing factors for OS, and SEER stage, receiving operative treatment or not, receiving chemotherapy or not, and receiving radiotherapy or not were independent influencing factors for CSS (all P<0.05). The OS [RR=0.61, 95%CI was (0.45, 0.81), P<0.001] and CSS [RR=0.67, 95%CI was (0.47, 0.95), P=0.025] in RSCC patients were significantly improved by surgical treatment. Conclusion Surgical treatment can improve the OS and CSS in RSCC patients.

Citation： HUANG Kun, HE Yunsheng, ZHAO Pan, ZHAO Pingwu. Effect of surgical treatment on prognosis in patients with rectal small cell neuroendocrine carcinoma based on SEER database. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2023, 30(2): 179-184. doi: 10.7507/1007-9424.202208041 Copy

1.	Chen ZZ, Huang W, Wei ZQ. Small-cell neuroendocrine carcinoma of the rectum - a rare tumor type with poor prognosis: A case report and review of literature. World J Clin Cases, 2020, 8(23): 6095-6102.
2.	Grossman RA, Pedroso FE, Byrne MM, et al. Does surgery or radiation therapy impact survival for patients with extrapulmonary small cell cancers? J Surg Oncol, 2011, 104(6): 604-612.
3.	陈忠胜, 李梁和, 张建栋, 等. 原发直肠肛管小细胞癌1例报告并文献复习. 中国普通外科杂志, 2020, 29(10): 1172-1177.
4.	WHO classification of tumours. Digestive system tumours. Lyon: IARC Press, 2019.
5.	Dasari A, Mehta K, Byers LA, et al. Comparative study of lung and extrapulmonary poorly differentiated neuroendocrine carcinomas: A SEER database analysis of 162 983 cases. Cancer, 2018, 124(4): 807-815.
6.	Alese OB, Jiang R, Shaib W, et al. High-grade gastrointestinal neuroendocrine carcinoma management and outcomes: A national cancer database study. Oncologist, 2019, 24(7): 911-920.
7.	Aytac E, Ozdemir Y, Ozuner G. Long term outcomes of neuroendocrine carcinomas (high-grade neuroendocrine tumors) of the colon, rectum, and anal canal. J Visc Surg, 2014, 151(1): 3-7.
8.	Dores GM, Qubaiah O, Mody A, et al. A population-based study of incidence and patient survival of small cell carcinoma in the United States, 1992-2010. BMC Cancer, 2015, 15: 185. doi: 10.1186/s12885-015-1188-y.
9.	Groeschl RT, Christians KK, Turaga KK, et al. Management of primary hepatopancreatobiliary small cell carcinoma. J Surg Oncol, 2013, 107(7): 692-695.
10.	Crippa S, Cirocchi R, Weiss MJ, et al. A systematic review of surgical resection of liver-only synchronous metastases from pancreatic cancer in the era of multiagent chemotherapy. Updates Surg, 2020, 72(1): 39-45.
11.	黄坤, 赵平武, 白斗, 等. 不同病理学类型的腹膜后脂肪肉瘤患者的预后分析及临床评价. 中国普通外科杂志, 2021, 30(10): 1212-1228.
12.	陈茂山, 李芳芳, 杨宏伟, 等. 基于SEER数据库分析142 007例乳腺癌诊断时婚姻状态与预后的关系. 重庆医科大学学报, 2020, 45(11): 1567-1572.
13.	Smith JD, Reidy DL, Goodman KA, et al. A retrospective review of 126 high-grade neuroendocrine carcinomas of the colon and rectum. Ann Surg Oncol, 2014, 21(9): 2956-2962.
14.	Lee H, Choi HJ, Park IY. Small cell carcinoma of the gallbladder: a case report. Ann Hepatobiliary Pancreat Surg, 2017, 21(3): 168-171.
15.	Bakogeorgos M, Kalkanis D, Katsaounis P, et al. Small cell carcinoma of the stomach: A report of two cases and a review of the literature. Mol Clin Oncol, 2018, 9(1): 11-16.
16.	Wu QQ, Qiang WG, Wang F, et al. Management of primary gastric small cell carcinoma in China. Int J Clin Exp Med, 2015, 8(2): 1589-1597.
17.	董锐增, 师英强, 叶延伟, 等. 23例胃低分化神经内分泌癌的临床病理特点和预后分析. 中华胃肠外科杂志, 2010, 13(8): 583-586.
18.	黄帅, 郑朝旭, 徐泉, 等. 胃小细胞癌41例临床病理特征与预后相关性分析. 中华外科杂志, 2013, 15(3): 225-229.
19.	Abdelfatah E, Guzzetta AA, Nagarajan N, et al. Long-term outcomes in treatment of retroperitoneal sarcomas: A 15 year single-institution evaluation of prognostic features. J Surg Oncol, 2016, 114(1): 56-64.
20.	Usmani S, Pazooki M, Bilgrami SF. Small cell carcinoma of the gall bladder: role of adjuvant chemotherapy. J Gastrointest Cancer, 2010, 41(1): 84-87.
21.	Modrek AS, Hsu HC, Leichman CG, et al. Radiation therapy improves survival in rectal small cell cancer-Analysis of Surveillance Epidemiology and End Results (SEER) data. Radiat Oncol, 2015, 10: 101. doi: 10.1186/s13014-015-0411-y.
22.	Choi PW. Synchronous small cell carcinoma and adenocarcinoma of the rectum. J Surg Case Rep, 2017, 2017(4): rjx069. doi: 10.1093/jscr/rjx069.
23.	Kanetkar AV, Patkar S, Khobragade KH, et al. Neuroendocrine carcinoma of gallbladder: A step beyond palliative therapy, experience of 25 cases. J Gastrointest Cancer, 2019, 50(2): 298-303.
24.	Song W, Chen W, Zhang S, et al. Successful treatment of gallbladder mixed adenoneuroendocrine carcinoma with neo-adjuvant chemotherapy. Diagn Pathol, 2012, 7: 163. doi: 10.1186/1746-1596-7-163.
25.	Jiao X, Pulgar S, Boyd M, et al. Treatment patterns and clinical outcomes in patients with metastatic gastroenteropancreatic neuroendocrine tumors treated in the community practice setting in the United States. Pancreas, 2018, 47(2): 173-182.
26.	Basuroy R, Haji A, Ramage JK, et al. Review article: the investigation and management of rectal neuroendocrine tumours. Aliment Pharmacol Ther, 2016, 44(4): 332-345.
27.	Fields AC, Lu P, Vierra BM, et al. Survival in patients with high-grade colorectal neuroendocrine carcinomas: The role of surgery and chemotherapy. Ann Surg Oncol, 2019, 26(4): 1127-1133.
28.	Brieau B, Lepère C, Walter T, et al. Radiochemotherapy versus surgery in nonmetastatic anorectal neuroendocrine carcinoma: A multicenter study by the association des gastro-entérologues oncologues. Medicine (Baltimore), 2015, 94(42): e1864. doi: 10.1097/MD.0000000000001864.

1. Chen ZZ, Huang W, Wei ZQ. Small-cell neuroendocrine carcinoma of the rectum - a rare tumor type with poor prognosis: A case report and review of literature. World J Clin Cases, 2020, 8(23): 6095-6102.
2. Grossman RA, Pedroso FE, Byrne MM, et al. Does surgery or radiation therapy impact survival for patients with extrapulmonary small cell cancers? J Surg Oncol, 2011, 104(6): 604-612.
3. 陈忠胜, 李梁和, 张建栋, 等. 原发直肠肛管小细胞癌1例报告并文献复习. 中国普通外科杂志, 2020, 29(10): 1172-1177.
4. WHO classification of tumours. Digestive system tumours. Lyon: IARC Press, 2019.
5. Dasari A, Mehta K, Byers LA, et al. Comparative study of lung and extrapulmonary poorly differentiated neuroendocrine carcinomas: A SEER database analysis of 162 983 cases. Cancer, 2018, 124(4): 807-815.
6. Alese OB, Jiang R, Shaib W, et al. High-grade gastrointestinal neuroendocrine carcinoma management and outcomes: A national cancer database study. Oncologist, 2019, 24(7): 911-920.
7. Aytac E, Ozdemir Y, Ozuner G. Long term outcomes of neuroendocrine carcinomas (high-grade neuroendocrine tumors) of the colon, rectum, and anal canal. J Visc Surg, 2014, 151(1): 3-7.
8. Dores GM, Qubaiah O, Mody A, et al. A population-based study of incidence and patient survival of small cell carcinoma in the United States, 1992-2010. BMC Cancer, 2015, 15: 185. doi: 10.1186/s12885-015-1188-y.
9. Groeschl RT, Christians KK, Turaga KK, et al. Management of primary hepatopancreatobiliary small cell carcinoma. J Surg Oncol, 2013, 107(7): 692-695.
10. Crippa S, Cirocchi R, Weiss MJ, et al. A systematic review of surgical resection of liver-only synchronous metastases from pancreatic cancer in the era of multiagent chemotherapy. Updates Surg, 2020, 72(1): 39-45.
11. 黄坤, 赵平武, 白斗, 等. 不同病理学类型的腹膜后脂肪肉瘤患者的预后分析及临床评价. 中国普通外科杂志, 2021, 30(10): 1212-1228.
12. 陈茂山, 李芳芳, 杨宏伟, 等. 基于SEER数据库分析142 007例乳腺癌诊断时婚姻状态与预后的关系. 重庆医科大学学报, 2020, 45(11): 1567-1572.
13. Smith JD, Reidy DL, Goodman KA, et al. A retrospective review of 126 high-grade neuroendocrine carcinomas of the colon and rectum. Ann Surg Oncol, 2014, 21(9): 2956-2962.
14. Lee H, Choi HJ, Park IY. Small cell carcinoma of the gallbladder: a case report. Ann Hepatobiliary Pancreat Surg, 2017, 21(3): 168-171.
15. Bakogeorgos M, Kalkanis D, Katsaounis P, et al. Small cell carcinoma of the stomach: A report of two cases and a review of the literature. Mol Clin Oncol, 2018, 9(1): 11-16.
16. Wu QQ, Qiang WG, Wang F, et al. Management of primary gastric small cell carcinoma in China. Int J Clin Exp Med, 2015, 8(2): 1589-1597.
17. 董锐增, 师英强, 叶延伟, 等. 23例胃低分化神经内分泌癌的临床病理特点和预后分析. 中华胃肠外科杂志, 2010, 13(8): 583-586.
18. 黄帅, 郑朝旭, 徐泉, 等. 胃小细胞癌41例临床病理特征与预后相关性分析. 中华外科杂志, 2013, 15(3): 225-229.
19. Abdelfatah E, Guzzetta AA, Nagarajan N, et al. Long-term outcomes in treatment of retroperitoneal sarcomas: A 15 year single-institution evaluation of prognostic features. J Surg Oncol, 2016, 114(1): 56-64.
20. Usmani S, Pazooki M, Bilgrami SF. Small cell carcinoma of the gall bladder: role of adjuvant chemotherapy. J Gastrointest Cancer, 2010, 41(1): 84-87.
21. Modrek AS, Hsu HC, Leichman CG, et al. Radiation therapy improves survival in rectal small cell cancer-Analysis of Surveillance Epidemiology and End Results (SEER) data. Radiat Oncol, 2015, 10: 101. doi: 10.1186/s13014-015-0411-y.
22. Choi PW. Synchronous small cell carcinoma and adenocarcinoma of the rectum. J Surg Case Rep, 2017, 2017(4): rjx069. doi: 10.1093/jscr/rjx069.
23. Kanetkar AV, Patkar S, Khobragade KH, et al. Neuroendocrine carcinoma of gallbladder: A step beyond palliative therapy, experience of 25 cases. J Gastrointest Cancer, 2019, 50(2): 298-303.
24. Song W, Chen W, Zhang S, et al. Successful treatment of gallbladder mixed adenoneuroendocrine carcinoma with neo-adjuvant chemotherapy. Diagn Pathol, 2012, 7: 163. doi: 10.1186/1746-1596-7-163.
25. Jiao X, Pulgar S, Boyd M, et al. Treatment patterns and clinical outcomes in patients with metastatic gastroenteropancreatic neuroendocrine tumors treated in the community practice setting in the United States. Pancreas, 2018, 47(2): 173-182.
26. Basuroy R, Haji A, Ramage JK, et al. Review article: the investigation and management of rectal neuroendocrine tumours. Aliment Pharmacol Ther, 2016, 44(4): 332-345.
27. Fields AC, Lu P, Vierra BM, et al. Survival in patients with high-grade colorectal neuroendocrine carcinomas: The role of surgery and chemotherapy. Ann Surg Oncol, 2019, 26(4): 1127-1133.
28. Brieau B, Lepère C, Walter T, et al. Radiochemotherapy versus surgery in nonmetastatic anorectal neuroendocrine carcinoma: A multicenter study by the association des gastro-entérologues oncologues. Medicine (Baltimore), 2015, 94(42): e1864. doi: 10.1097/MD.0000000000001864.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Effect of surgical treatment on prognosis in patients with rectal small cell neuroendocrine carcinoma based on SEER database

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