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Prognostic relevance of neuroendocrine differentiation in colorectal cancer: a population-based, propensity score matching study

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International Journal of Colorectal Disease Aims and scope Submit manuscript

Abstract

Purpose

Neuroendocrine differentiation (NED) may serve as a prognostic factor in colorectal cancer; however, the prognostic relevance of NED remains controversial. The aim of the present study was to determine whether NED influenced the survival of patients in colorectal cancer while exploring its potential interactions with other clinicopathological features.

Methods

Patients with primary stage I to IV colorectal adenocarcinoma ranging between 2010 and 2015 were identified using the Surveillance, Epidemiology, and End Results database. The Kaplan-Meier technique, Cox proportional hazards model, propensity score matching, and stratification analyses were employed in this study.

Results

A total of 94,291 patients (including 101 patients with NED and 94,190 patients without NED) were included. In the univariable analyses, NED was found to be correlated with a significantly poorer overall survival (hazard ratio (HR) of death = 3.09, 95% CI 2.42–3.95, P < 0.001) and cancer-specific survival (HR of death = 3.77, 95% CI 2.94–4.83, P < 0.001). Moreover, NED remained independently correlated with overall survival (HR of death = 1.84, 95% CI 1.34–2.51, P < 0.001) and cancer-specific survival (HR of death = 2.01, 95% CI 1.45–2.79, P < 0.001) after adjusting in multivariable and propensity score analyses. Furthermore, further stratification analyses indicated that the influence of NED on survival was not affected by tumor location, differentiation, T stage, and distant metastasis status; however, it was found to be associated with lymph node metastasis.

Conclusions

NED is associated with poor survival outcomes among colorectal cancer patients, especially in those with positive lymph nodes.

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Data availability

All data in this study can be obtained from http://seer.cancer.gov/.

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Acknowledgments

The authors would like to thank Prof. Yang Tubao (Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University) for his contribution of statistical analyses and all the staff members of the National Cancer Institute who have participated in the Surveillance, Epidemiology, and End Results program for open access to their database.

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Authors and Affiliations

  1. Department of General Surgery, Xiangya Hospital, Central South University, 87th Xiangya Rd, Kaifu District, Changsha, 410000, Hunan, China

    Jianping Guo, Peilin Zheng, Ran Wang, Xiangzhou Tan, Weimin Yang, Shihan Xiao & Zhikang Chen

  2. National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China

    Jianping Guo, Peilin Zheng, Ran Wang, Xiangzhou Tan, Weimin Yang, Shihan Xiao & Zhikang Chen

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  1. Jianping Guo
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Contributions

All authors meet the ICMJE authorship criteria and contributed substantially to the manuscript. Jianping Guo: conceptualization, data curation, statistical analysis, writing the original draft

Peilin Zheng: data curation, statistical analysis, writing the original draft

Ran Wang and Xiangzhou Tan: writing reviewing and editing

Weimin Yang and Shihan Xiao: data curation, statistical analysis, visualization

Zhikang Chen: conceptualization, supervision, project administration, writing reviewing, and editing

Corresponding author

Correspondence to Zhikang Chen.

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The authors declare that they have no conflict of interest.

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As this study is based on a publicly available database without identifying patient information, informed consent was not needed.

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ESM 1

Forest plot showing results of multivariate Cox regression model for exploring potential risk factors for overall survival (OS) and cancer-specific survival (CSS) in the propensity score-adjusted cohort (PNG 1346 kb)

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Guo, J., Zheng, P., Wang, R. et al. Prognostic relevance of neuroendocrine differentiation in colorectal cancer: a population-based, propensity score matching study. Int J Colorectal Dis 35, 2185–2195 (2020). https://doi.org/10.1007/s00384-020-03708-6

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  • DOI: https://doi.org/10.1007/s00384-020-03708-6

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