A study of clinical characteristics and prognostic factors of 49 patients with gastric neuroendocrine neoplasm treated with radical surgery        LI Jian-ang*, HAN Xu, FANG Yuan, et al. *Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, China
Corresponding author: XU Xue-feng, E-mail: xuefengxu87@aliyun.com
Abstract    Objective    To study and explore the clinical characteristics and prognostic factors of patients with gastric neuroendocrine neoplasms (g-NENs) treated with radical surgeries. Methods    The clinical and pathological data of 49 g-NENs patients who underwent surgery from January 2002 to December 2011 at the Zhongshan Hospital of Fudan University were analyzed retrospectively. The neoplasms were nominated and classified into different grades and stages according to the latest WHO classification of g-NENs. Follow-up was conducted by telephone, mail or returning visit survey. The overall survival rates were calculated and the survival curves were drawn using the Kaplan-Meier method. Univariate analysis was performed by the Log-rank test, and multivariate analysis was performed by the COX proportional hazards model. Results    Among the 49 g-NENs patients, 37 were male and 12 were female, with an average age of 66 years. 6 neuroendocrine tumors (including G1 and G2) and 43 neuroendocrine carcinomas (G3). The tumor sizes ranged from 1.5cm×2.5cm×0.5cm~7cm×8cm×1.5cm. 15 NENs were localized, 33 had lymph node involvement and 1 had hepatic metastasis. At the end of the follow-up, the follow-up rate was 98.0% (48/49), and the median follow-up time was 22.2 months. The median overall survival rate of g-NENs patients was 43 months, and the overall 1-, 2-, and 5-year survival rates were 85.7%, 50.7%, 41.6% respectively. Sex (χ2=6.359，P<0.05) and lymph node involvement (χ2=4.036，P<0.05) were prognostic factors of postoperative g-NENs patients, among which sex was an independent prognostic factor (P<0.05). Conclusions    Most of the patients with g-NENs had nonspecific symptoms. When diagnosed, lymph node or distant metastases were present in most patients. Female patients had a survival advantage.