Evaluation of clinicopathological features of neuroendocrine tumors

SUMMARY Introduction and purpose: Neuroendocrine tumors (NETs) are a heterogeneous group of neoplasms originating from many organs and exhibiting changes in etiological, genetic, biological, morphological and clinical aspects. The fact that the incidence of neuroendocrine tumors has recently increased in our country, as in the rest of the world, and the insufficient number of comprehensive studies on this subject in our country has led us to conduct this study. The aim of this study is to determine the clinicopathological features and survival analysis of cases with a diagnosis of neuroendocrine tumor (NET). In our study, we retrospectively analyzed the demographic data of patients with NET (such as age, gender), disease stages at admission, treatments they received, progression status, final status and survival time in line with the information in the hospital records. Material and Method: In this study, the data of patients diagnosed with Neuroendocrine Tumor (n=145) who applied to the Oncology Department of Dicle University Medical Faculty Hospital between January 2012 and December 2022 were analyzed retrospectively. Patients' age, gender, ecog score, complaint of admission, date of diagnosis, pathological stage, grade, primary tumor localization, location of tumor metastasis, stage at diagnosis, whether or not they received chemotherapy, Ki-67 percentage, CgA level, Gallium 68 PET SUV' of primary tumor Disease-free survival and overall survival were analyzed according to u , Mitosis Number, presence of carcinoid syndrome, surgical status, radionuclide therapy, and progression status after chemotapy. The data of the patients were determined by compiling pathology reports, medical oncology archive data, laboratory tests, prescriptions and patient epicrisis via HIMS (Hospital Information Management System). The overall survival status was calculated according to the date of last admission and the date of death of the patient. Results : Of the patients, 75 (51.7%) were male and 70 (48.3%) were female. The median age of diagnosis of the patients was 55 (20-92). When the frequency of primary tumor site was examined, lung 30 (20.7%) patients, stomach 31 (21.4%) patients, pancreas 34 (23.4%) patients, small intestine 10 (6.9%) patients, colorectal 4 (%) patients 2.8) patients, appendix 6 (4.1%) patients, 11 (7.6%) patients with unknown primary, and 19 (13.1%) patients at other sites. Considering the disease stages at the time of diagnosis, 37 (25.5%) patients were diagnosed as stage 1, 12 (8.3%) patients as stage 2, 15 (10.3%) patients as stage 3 and 81 (55.9%) patients as stage 4. appeared to be. Of these patients with NET, 38 patients (26.2%) with an ECOG score of 0, 76 people with an ECOG score of 1 (52.4%), 23 patients with an ECOG score of 2 (15.9%), 8 people with an ECOG score of 3 (5%) ,5 ) was determined. In all patients (n=145), 3-year overall survival was 62%, while 5-year overall survival was 51%. The mean disease-free survival time in all patients (n=145) was 62 months (95% CI 41.3-83.9). When compared in terms of overall survival times between men and women, women live longer than men, and in statistical analysis, the effect of gender on overall survival was significant (p=0.024). When the effect of ECOG Performance score on survival was examined, a statistically superior difference in survival was found in patients with good performance. (P<0.001) When the effect of the grades of the patients at the time of the disease on survival was examined, statistically better survival rate was found in the low grade group. (P<0.001) When the effect of disease stage at the time of the disease on survival was examined, it was determined that there was a statistically significant difference with superior survival time in the early stage (P=0.001). When the overall survival analysis of the treatment regimens applied to the patients was performed, octreotide/lantreotide median survival was 90 months (95%CI; 48.3-131.7), chemotherapy median survival was 23 months (95% CI; 5.9-41.7), octreotide The median survival time of /lantreotide+chemotherapy was 38 months (95% CI; 16-61.9). A statistical difference was found between the treatment regimens.(p=0.001) When the overall survival analysis of radionuclide therapy applied to the patients was performed, the median survival time was calculated as 103 months in patients who received radionuclide therapy and 53 months (95% CI; 31-76) in patients who did not receive radionuclide therapy. A statistically significant difference was observed when the effect of radionuclide therapy on survival was examined. not detected.(p=0.072) Stage (p=0.005), Grade (p<0.009), ECOG score (p=0.001), treatment regimen (p=0.001) and Gender (p=0.011) were determined as parameters that may affect overall survival. Statistical Analysis Statistical analyzes of the data we obtained in this study were carried out using the application named SPSS (Statistical Package for the Social Sciences) 24. Kaplan-Meier Method and Cox Regression Analysis were used for survival analysis. Our data were considered statistically significant when the p (probability) value was found to be less than 0.05 in all of our study tests. Conclusion: In our study, it has been shown that ECOG performance score, Pathological grade, and Stage have prognostic features in NET patients. In addition, survival is prolonged in patient groups receiving Somatostatin analog therapy alone or in combination with other treatments. Keywords: Neuroendocrine Tumor (NET)