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Mixed adenoneuroendocrine carcinoma originating from the appendix and colorectum: a comparative analysis of a large population-based database

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Abstract

Purpose

As a rare gastrointestinal neoplasm, the demographic, clinicopathological, and prognostic characteristics of mixed adenoneuroendocrine carcinoma (MANEC) remain unclear. The purpose of this study was to evaluate its biological features, survival outcome, and prognostic factors.

Methods

From the Surveillance, Epidemiology, and End Results (SEER) database, we retrospectively reviewed clinicopathological and survival data of 513 patients who were histopathologically diagnosed with MANEC of the appendix and colorectum bettween 2004 and 2015. The clinicopathological features and survival outcomes of MANEC located at different anatomical locations were compared, and predictive factors for cancer-specific survival (CSS) and overall survival (OS) were assessed.

Results

In terms of anatomical distribution of MANEC, the appendix (64.5%, 331/513) was more frequently involved, followed by colon (28.1%, 144/513) and rectum (7.4%, 38/513). The MANEC at different anatomical locations had a distinct clinicopathological characteristic, and colorectal MANEC was significantly associated with more aggressive biological features. The survival outcomes of appendiceal MANEC were significantly better than that of colorectal MANEC (3-year CSS rate 73.8% vs 59.4%, P = 0.010; 3-year OS 69.2% vs 48.3%, P < 0.001). In addition, hemicolectomy had a better survival benefit than appendicectomy for patients with appendiceal MANEC, regardless of lymph node metastasis (P < 0.05). Tumor location, histology grade III, tumor size > 2 cm, T3–T4 stage, lymph node metastasis, and distant metastasis were independent prognostic factors for patients with MANEC.

Conclusions

Tumor location had an important prognostic significance for MANEC. As an uncommon clinical entity, colorectal MANEC had more aggressive biological features and worse prognosis than its appendiceal counterpart. The standard surgical procedure and clinical management strategy for MANEC need to be established.

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Funding

This work was supported by the Tianjin Health Science and Technology Project (NO.ZC20213).

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Authors and Affiliations

  1. Department of Gastrointestinal Surgery, Tianjin First Central Hospital, No.24 Fukang Road, Nankai District, Tianjin, 300190, People’s Republic of China

    Bochao Zhao, Jingchao Wang, Haikun Ye, Xinghao Cheng, Kewei Meng & Tao Yang

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  1. Bochao Zhao
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  2. Jingchao Wang
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  3. Haikun Ye
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  4. Xinghao Cheng
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  5. Kewei Meng
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  6. Tao Yang
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Correspondence to Bochao Zhao or Tao Yang.

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The authors declare that they have no conflict of interest.

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No ethical approval and informed consent were required for this analysis, and the data of all participants were obtained from a deidentifed, publicly available database.

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Zhao, B., Wang, J., Ye, H. et al. Mixed adenoneuroendocrine carcinoma originating from the appendix and colorectum: a comparative analysis of a large population-based database. Tech Coloproctol 27, 1017–1024 (2023). https://doi.org/10.1007/s10151-023-02786-2

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  • DOI: https://doi.org/10.1007/s10151-023-02786-2

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