Article
Prognostic factors influencing long-term survival in neuroendocrine neoplasms of the jejuno-ileum
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Published: | April 21, 2016 |
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Background: Neuroendocrine neoplasms (NEN) of the ileum are rare submucosal tumors that are often diagnosed at advanced stages with metastatic spread to the liver so that surgery is limited in most patients. Data on survival is scarce and not much is known about factors influencing survival.
Materials and methods: Data from all patients who underwent surgery for a neuroendocrine neoplasm of the ileum between 2000 and 2014 were retrieved from a prospective database. For each patient, gender, age at surgery of the primary, comorbidity, TNM-Classification, Ki67%, symptoms at diagnosis, status in somatostatin receptor scintigraphy, lymph node and liver metastasis, lymph node ratio, surgical procedure performed, localisation of the primary, blood group, rhesus factor, and preoperative CRP were recorded. Furthermore we recorded the time of follow up after the primary surgery for those patients who are still alive or the date of death.
Results: 125 patients were identified. After a median follow up of 48 months (range 1-157) 71 patients (56,8%) were still alive (Group I), 47 patients (37.6%) had already died (Group II) and 7 patients (5.6%) were lost to follow up. We could find statistically significant differences in survival depending on lymph node ratio. Patients still alive had a mean lymph node ratio of 0.158, whereas patients who died had a lymph node ratio of 0.488 (p=0.000). Between Group I and II there was a statistically significant difference concerning tumor localisation, surgical procedure, somatostatin receptor status and symptoms at diagnosis.
Conclusion: Localised and regionally restricted ileojejunal NEN have an excellent prognosis after surgical treatment. Lymph node ratio is a new detected prognostic factor in NEN of the jejuno-ileum and radical lymphadenectomy should be performed.