Current Trends of the Incidence and Pathological Diagnosis of Gastroenteropancreatic Neuroendocrine Tumors (GEP-NETs) in Korea 2000-2009: Multicenter Study
- Current Trends of the Incidence and Pathological Diagnosis of Gastroenteropancreatic Neuroendocrine Tumors (GEP-NETs) in Korea 2000-2009: Multicenter Study
- 구미진; 최준혁; 손진희[손진희]; 조미연[조미연]; 김준미[김준미]; 김미정[김미정]; 김경미[김경미]; 김우호[김우호]; 김현기[김현기]; 국명철[국명철]; 박도윤[박도윤]; 이재혁[이재혁]; 장희경[장희경]; 정은선[정은선]; 김희경[김희경]; 진소영[진소영]; 김수진[김수진]; 강미선[강미선]; 조창호[조창호]; 박문일[박문일]; 강윤경[강윤경]; 김윤화[김윤화]; 윤선오[윤선오]; 배한익[배한익]; 주미[주미]; 문우성[문우성]; 강대영[강대영]; 장세진[장세진]
- Gastro-enteropancreatic neuroendocrine tumor; Incidence; Prognosis; Pathology
- Issue Date
- Cancer Research and Treatment, v.44, no.3, pp.157 - 165
- Purpose As a result of various independently proposed nomenclatures and classifications, there is confusion in the diagnosis and prediction of biological behavior of gastroenteropancreatic neuroendocrine tumors (GEP-NETs). A comprehensive nationwide study is needed in order to understand the biological characteristics of GEP-NETs in Korea.
Materials and Methods We collected 4,951 pathology reports from 29 hospitals in Korea between 2000 and 2009. Kaplan-Meier survival analysis was used to determine the prognostic significance of clinicopathological parameters.
Results Although the GEP-NET is a relatively rare tumor in Korea, its incidence has increased during the last decade, with the most significant increase found in the rectum. The 10-year survival rate for well-differentiated endocrine tumor was 92.89%, in contrast to 85.74% in well differentiated neuroendocrine carcinoma and 34.59% in poorly differentiated neuroendocrine carcinoma.
Disease related death was most common in the biliary tract (62.2%) and very rare in the rectum (5.2%). In Kaplan-Meier survival analysis, tumor location, histological classification, extent, size,mitosis, Ki-67 labeling index, synaptophysin expression, lymphovascular invasion, perineural invasion, and lymph node metastasis showed prognostic significance (p＜0.05), however, chromogranin expression did not (p=0.148). The 2000 and 2010 World Health Organization (WHO)classification proposals were useful for prediction of the prognosis of GEP-NET.
Conclusion The incidence of GEP-NET in Korea has shown a remarkable increase during the last decade,however, the distribution of tumors in the digestive system differs from that of western reports.
Assessment of pathological parameters, including immunostaining, is crucial in understanding biological behavior of the tumor as well as predicting prognosis of patients with GEP-NET.
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