Analysis of 72 patients with colorectal high-grade neuroendocrine neoplasms from three Chinese hospitals

Table 1 Patient characteristics

Characteristic	Patients (n = 72)
Sex, n (%)
Male	52 (72.2)
Female	20 (27.8)
Age [yr, median (range)]	59.5 (18-82)
BMI (kg/m2, mean ± SD)	23.8 ± 3.4
Symptoms, n (%)
Hematochezia	37 (51.4)
Abdominal pain	23 (31.9)
Changes in bowel habits	23 (31.9)
Obstruction	12 (16.7)
Abdominal distention	5 (9.6)
Weight loss	3 (4.2)
Anemia	2 (2.8)
Carcinoid syndrome	0
Asymptomatic	2 (2.8)
Family history of cancer, n (%)
Yes	11 (15.3)
No	60 (83.3)
Unrecorded	1 (1.4)
History of colorectal polyps, n (%)
Yes	24 (33.3)
No	27 (37.5)
Unrecorded	21 (29.2)
Smoking history, n (%)
Yes	28 (38.9)
No	42 (58.3)
Unrecorded	2 (2.8)
Drinking history, n (%)
Yes	24 (33.3)
No	45 (62.5)
Unrecorded	3 (4.2)
Primary sites, n (%)
Rectum	46 (63.9)
Rectosigmoid junction	2 (2.8)
Sigmoid	5 (6.9)
Descending colon	4 (5.6)
Transverse colon	2 (2.8)
Ascending colon	9 (12.5)
Cecum	4 (5.6)
Distance of tumor from the anal verge [(for rectal carcinoma, n = 46), n (%)]
0-5 cm	28 (60.9)
5-10 cm	14 (19.4)
10-15 cm	2 (2.8)
Unrecorded	2 (2.8)
Tumor size [median (range), cm]	5.0 (1.0-15.0)
Tumor stage, n (%)
I	4 (5.6)
II	4 (5.6)
III	27 (37.5)
IV	37 (51.4)
Site of distant metastases, n (%)
Liver	27 (37.5)
Liver only	12 (16.6)
Distant lymph nodes	15 (20.8)
Peritoneum	5 (6.9)
Bone	5 (6.9)
Lung	1 (1.4)
Pancreas	1 (1.4)
Increase of pretreatment blood LDH, n (%)
Yes	10 (13.9)
No	29 (40.3)
Unrecorded	33 (45.8)

BMI: Body mass index; SD: Standard deviation; LDH: Lactic dehydrogenase.

Table 2 Pathological features

Histology, n (%)	Patients (n = 72)
NEC	61 (84.7)
NET G3	11 (15.3)
General classification of tumor, n (%)
Ulcerative type	29 (40.3)
Protruding type	29 (40.3)
Unrecorded	14 (19.4)
Synaptophysin, n (%)
Positive	63 (87.5)
Negative	4 (5.6)
Unrecorded	5 (6.9)
Chromogranin, n (%)
Positive	38 (52.8)
Negative	28 (38.9)
Unrecorded	6 (8.3)
Neuron specific enolase, n (%)
Positive	9 (12.5)
Negative	5 (6.9)
Unrecorded	58 (80.6)
CD56, n (%)
Positive	42 (58.3)
Negative	9 (12.5)
Unrecorded	21 (29.2)
CDX-2, n (%)
Positive	18 (25)
Negative	11 (15.3)
Unrecorded	43 (59.7)
TTF-1, n (%)
Positive	2 (2.8)
Negative	11 (15.3)
Unrecorded	59 (81.9)
Ki 67 (median, range)	70% (25%-95%)
EMVI, n (%)
Yes	29 (40.3)
No	9 (12.5)
Unrecorded	34 (47.2)
Perineural invasion, n (%)
Yes	8 (11.1)
No	29 (40.3)
Unrecorded	35 (48.6)

NEC: Neuroendocrine carcinoma; NET: Neuroendocrine tumor; EMVI: Extramural vascular invasion.

Table 3 Management of patients with localized disease

Treatment strategy	Patients (n = 35)
Nonsurgical treatment	1
Surgery alone	6
Surgery + adjuvant treatment	23
Neoadjuvant treatment + surgery + adjuvant treatment	5

Table 4 Survival analysis of overall survival

Variable	Univariate analysis		Multivariate analysis
	Median OS	P-value	HR (95%CI)	P-value
Sex		0.095	1.374 (0.664-2.845)	0.392
Male	39
Female	18
Age (yr)		<0.001	3.926 (1.740-8.858)	0.001
<70	47
≥70	8
Radical surgery		<0.001	0.778 (0.338-1.792)	0.555
Yes	39
No	8
Tumor location		0.386	1.592 (0.738-3.434)	0.236
Colon	15
Rectum	35
Gross type		0.037
Ulcerative	18
Protruding	imponderable
Distant metastasis		<0.001	6.356 (2.543-15.889)	<0.001
Yes	13
No	imponderable
Pathologic type		0.033	6.647 (1.759-25.119)	0.005
NEC	25
NET G3	imponderable
Ki67 index		0.893
<55%	39
≥55%	35
EMVI		0.047
Yes	26
No	Imponderable
Perineural invasion		0.944
Yes	26
No	39
Pretreatment bloodLDH level		0.015
Elevated	7
Not elevated	26

OS: Overall survival; CI: Confidence interval; NEC: Neuroendocrine carcinoma; NET: Neuroendocrine tumor; EMVI: Extramural vascular invasion; LDH: Lactic dehydrogenase; HR: Hazard ratio; NET G3: Neuroendocrine tumor G3.