Management of resectable esophageal and gastric (mixed adeno)neuroendocrine carcinoma: A nationwide cohort study

A. van der Veen; M. F.J. Seesing; B. P.L. Wijnhoven; W. O. de Steur; M. I. van Berge Henegouwen; C. Rosman; J. W. van Sandick; S. Mook; N. Haj Mohammad; J. P. Ruurda; L. A.A. Brosens; R. van Hillegersberg; Y. A. Alderlieste; P. C. Baas; E. J.T. Belt; C. Ünlü; J. W.D. de Waard; P. Duijvendijk; J. Heisterkamp; E. A. Kouwenhoven; G. A.P. Nieuwenhuijzen; E. G.J.M. Pierik; J. T.M. Plukker; A. Pronk; A. M. Rijken; J. J.G. Scheepers; J. H. Stoot; G. W.M. Tetteroo; G. J.D. van Acker; E. van der Harst; D. L. van der Peet

doi:10.1016/j.ejso.2018.07.058

Management of resectable esophageal and gastric (mixed adeno)neuroendocrine carcinoma: A nationwide cohort study

A. van der Veen, M. F.J. Seesing, B. P.L. Wijnhoven, W. O. de Steur, M. I. van Berge Henegouwen, C. Rosman, J. W. van Sandick, S. Mook, N. Haj Mohammad, J. P. Ruurda, L. A.A. Brosens, R. van Hillegersberg^*, Y. A. Alderlieste, P. C. Baas, E. J.T. Belt, C. Ünlü, J. W.D. de Waard, P. Duijvendijk, J. Heisterkamp, E. A. KouwenhovenG. A.P. Nieuwenhuijzen, E. G.J.M. Pierik, J. T.M. Plukker, A. Pronk, A. M. Rijken, J. J.G. Scheepers, J. H. Stoot, G. W.M. Tetteroo, G. J.D. van Acker, E. van der Harst, D. L. van der Peet,

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

Introduction: The aim of this study is to provide insight in accuracy of diagnosing, current treatment and survival in patients with resectable esophageal and gastric neuroendocrine- and mixed adenoneuroendocrine carcinomas (NEC, MANEC). Methods: All patients with esophageal or gastric (MA)NEC, who underwent surgical resection between 2006 and 2016, were identified from the Dutch national registry for histo- and cytopathology (PALGA). Patients with a neuroendocrine tumor lower than grade 3 were excluded. Data on patients, treatment and outcomes were retrieved from the patient records. Diagnosis by endoscopic biopsy was compared with diagnosis by resection specimen. Kaplan Meier survival analysis was performed. Results: A total of 49 patients were identified in 25 hospitals, including 21 patients with esophageal (MA)NEC and 26 patients with gastric (MA)NEC on resection specimen. Biopsy diagnosis of (MA)NEC was correct in 23/27 patients. However, 20/47 patients with definitive diagnosis of (MA)NEC, were misdiagnosed on biopsy. Neoadjuvant therapy was administered in 13 (62%) esophageal (MA)NECs and 12 (46%) gastric (MA)NECs. Survival curves were similar with and without neoadjuvant therapy. One (4.8%) esophageal (MA)NEC and 4 (15%) gastric (MA)NECs died within 90 days postoperatively. For esophageal (MA)NEC the median overall survival (OS) after surgery was 37 months and 1-, 3- and 5-year OS were 71%, 50% and 35%, respectively. For gastric (MA)NEC, the median OS was 23 months and 1-, 3- and 5-year OS were 62%, 50% and 39%, respectively. Conclusion: Localized esophageal and gastric (MA)NEC are often misdiagnosed on endoscopic biopsies. After resection, long-term survival was achieved in respectively 35% and 39% of patients.

Original language	English
Pages (from-to)	1955-1962
Number of pages	8
Journal	European Journal of Surgical Oncology
Volume	44
Issue number	12
Early online date	2 Aug 2018
DOIs	https://doi.org/10.1016/j.ejso.2018.07.058
Publication status	Published - Dec 2018

Keywords

Biopsy diagnosis
Esophagectomy
Gastrectomy
Mixed adenoneuroendocrine carcinoma
Neoadjuvant therapy
Neuroendocrine carcinoma
Stomach Neoplasms/mortality
Esophageal Neoplasms/mortality
Humans
Middle Aged
Male
Survival Rate
Treatment Outcome
Adenocarcinoma/mortality
Neoplasm Grading
Biopsy
Postoperative Complications/epidemiology
Carcinoma, Neuroendocrine/mortality
Female
Neoadjuvant Therapy
Aged
Netherlands/epidemiology

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10.1016/j.ejso.2018.07.058

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van der Veen, A., Seesing, M. F. J., Wijnhoven, B. P. L., de Steur, W. O., van Berge Henegouwen, M. I., Rosman, C., van Sandick, J. W., Mook, S., Haj Mohammad, N., Ruurda, J. P., Brosens, L. A. A., van Hillegersberg, R., Alderlieste, Y. A., Baas, P. C., Belt, E. J. T., Ünlü, C., de Waard, J. W. D., Duijvendijk, P., Heisterkamp, J. (2018). Management of resectable esophageal and gastric (mixed adeno)neuroendocrine carcinoma: A nationwide cohort study. European Journal of Surgical Oncology, 44(12), 1955-1962. https://doi.org/10.1016/j.ejso.2018.07.058

@article{b36e8d4fc923499f85325dba86e3d1bd,

title = "Management of resectable esophageal and gastric (mixed adeno)neuroendocrine carcinoma: A nationwide cohort study",

abstract = "Introduction: The aim of this study is to provide insight in accuracy of diagnosing, current treatment and survival in patients with resectable esophageal and gastric neuroendocrine- and mixed adenoneuroendocrine carcinomas (NEC, MANEC). Methods: All patients with esophageal or gastric (MA)NEC, who underwent surgical resection between 2006 and 2016, were identified from the Dutch national registry for histo- and cytopathology (PALGA). Patients with a neuroendocrine tumor lower than grade 3 were excluded. Data on patients, treatment and outcomes were retrieved from the patient records. Diagnosis by endoscopic biopsy was compared with diagnosis by resection specimen. Kaplan Meier survival analysis was performed. Results: A total of 49 patients were identified in 25 hospitals, including 21 patients with esophageal (MA)NEC and 26 patients with gastric (MA)NEC on resection specimen. Biopsy diagnosis of (MA)NEC was correct in 23/27 patients. However, 20/47 patients with definitive diagnosis of (MA)NEC, were misdiagnosed on biopsy. Neoadjuvant therapy was administered in 13 (62%) esophageal (MA)NECs and 12 (46%) gastric (MA)NECs. Survival curves were similar with and without neoadjuvant therapy. One (4.8%) esophageal (MA)NEC and 4 (15%) gastric (MA)NECs died within 90 days postoperatively. For esophageal (MA)NEC the median overall survival (OS) after surgery was 37 months and 1-, 3- and 5-year OS were 71%, 50% and 35%, respectively. For gastric (MA)NEC, the median OS was 23 months and 1-, 3- and 5-year OS were 62%, 50% and 39%, respectively. Conclusion: Localized esophageal and gastric (MA)NEC are often misdiagnosed on endoscopic biopsies. After resection, long-term survival was achieved in respectively 35% and 39% of patients.",

keywords = "Biopsy diagnosis, Esophagectomy, Gastrectomy, Mixed adenoneuroendocrine carcinoma, Neoadjuvant therapy, Neuroendocrine carcinoma, Stomach Neoplasms/mortality, Esophageal Neoplasms/mortality, Humans, Middle Aged, Male, Survival Rate, Treatment Outcome, Adenocarcinoma/mortality, Neoplasm Grading, Biopsy, Postoperative Complications/epidemiology, Carcinoma, Neuroendocrine/mortality, Female, Neoadjuvant Therapy, Aged, Netherlands/epidemiology",

author = "{van der Veen}, A. and Seesing, {M. F.J.} and Wijnhoven, {B. P.L.} and {de Steur}, {W. O.} and {van Berge Henegouwen}, {M. I.} and C. Rosman and {van Sandick}, {J. W.} and S. Mook and {Haj Mohammad}, N. and Ruurda, {J. P.} and Brosens, {L. A.A.} and {van Hillegersberg}, R. and Alderlieste, {Y. A.} and Baas, {P. C.} and Belt, {E. J.T.} and C. {\"U}nl{\"u} and {de Waard}, {J. W.D.} and P. Duijvendijk and J. Heisterkamp and Kouwenhoven, {E. A.} and Nieuwenhuijzen, {G. A.P.} and Pierik, {E. G.J.M.} and Plukker, {J. T.M.} and A. Pronk and Rijken, {A. M.} and Scheepers, {J. J.G.} and Stoot, {J. H.} and Tetteroo, {G. W.M.} and {van Acker}, {G. J.D.} and {van der Harst}, E. and {van der Peet}, {D. L.}",

note = "Funding Information: The authors would like to thank the Dutch national registry for histo- and cytopathology (PALGA) for identification of the patients, with special thanks to mr. Voorham (PALGA, the Netherlands). Publisher Copyright: {\textcopyright} 2018 Copyright: Copyright 2019 Elsevier B.V., All rights reserved.",

year = "2018",

month = dec,

doi = "10.1016/j.ejso.2018.07.058",

language = "English",

volume = "44",

pages = "1955--1962",

journal = "European Journal of Surgical Oncology",

issn = "0748-7983",

publisher = "W.B. Saunders Ltd",

number = "12",

}

van der Veen, A, Seesing, MFJ, Wijnhoven, BPL, de Steur, WO, van Berge Henegouwen, MI, Rosman, C, van Sandick, JW, Mook, S, Haj Mohammad, N , Ruurda, JP , Brosens, LAA , van Hillegersberg, R, Alderlieste, YA, Baas, PC, Belt, EJT, Ünlü, C, de Waard, JWD, Duijvendijk, P, Heisterkamp, J, Kouwenhoven, EA, Nieuwenhuijzen, GAP, Pierik, EGJM, Plukker, JTM, Pronk, A, Rijken, AM, Scheepers, JJG, Stoot, JH, Tetteroo, GWM, van Acker, GJD, van der Harst, E, van der Peet, DL 2018, 'Management of resectable esophageal and gastric (mixed adeno)neuroendocrine carcinoma: A nationwide cohort study', European Journal of Surgical Oncology, vol. 44, no. 12, pp. 1955-1962. https://doi.org/10.1016/j.ejso.2018.07.058

TY - JOUR

T1 - Management of resectable esophageal and gastric (mixed adeno)neuroendocrine carcinoma

T2 - A nationwide cohort study

AU - van der Veen, A.

AU - Seesing, M. F.J.

AU - Wijnhoven, B. P.L.

AU - de Steur, W. O.

AU - van Berge Henegouwen, M. I.

AU - Rosman, C.

AU - van Sandick, J. W.

AU - Mook, S.

AU - Haj Mohammad, N.

AU - Ruurda, J. P.

AU - Brosens, L. A.A.

AU - van Hillegersberg, R.

AU - Alderlieste, Y. A.

AU - Baas, P. C.

AU - Belt, E. J.T.

AU - Ünlü, C.

AU - de Waard, J. W.D.

AU - Duijvendijk, P.

AU - Heisterkamp, J.

AU - Kouwenhoven, E. A.

AU - Nieuwenhuijzen, G. A.P.

AU - Pierik, E. G.J.M.

AU - Plukker, J. T.M.

AU - Pronk, A.

AU - Rijken, A. M.

AU - Scheepers, J. J.G.

AU - Stoot, J. H.

AU - Tetteroo, G. W.M.

AU - van Acker, G. J.D.

AU - van der Harst, E.

AU - van der Peet, D. L.

N1 - Funding Information: The authors would like to thank the Dutch national registry for histo- and cytopathology (PALGA) for identification of the patients, with special thanks to mr. Voorham (PALGA, the Netherlands). Publisher Copyright: © 2018 Copyright: Copyright 2019 Elsevier B.V., All rights reserved.

PY - 2018/12

Y1 - 2018/12

N2 - Introduction: The aim of this study is to provide insight in accuracy of diagnosing, current treatment and survival in patients with resectable esophageal and gastric neuroendocrine- and mixed adenoneuroendocrine carcinomas (NEC, MANEC). Methods: All patients with esophageal or gastric (MA)NEC, who underwent surgical resection between 2006 and 2016, were identified from the Dutch national registry for histo- and cytopathology (PALGA). Patients with a neuroendocrine tumor lower than grade 3 were excluded. Data on patients, treatment and outcomes were retrieved from the patient records. Diagnosis by endoscopic biopsy was compared with diagnosis by resection specimen. Kaplan Meier survival analysis was performed. Results: A total of 49 patients were identified in 25 hospitals, including 21 patients with esophageal (MA)NEC and 26 patients with gastric (MA)NEC on resection specimen. Biopsy diagnosis of (MA)NEC was correct in 23/27 patients. However, 20/47 patients with definitive diagnosis of (MA)NEC, were misdiagnosed on biopsy. Neoadjuvant therapy was administered in 13 (62%) esophageal (MA)NECs and 12 (46%) gastric (MA)NECs. Survival curves were similar with and without neoadjuvant therapy. One (4.8%) esophageal (MA)NEC and 4 (15%) gastric (MA)NECs died within 90 days postoperatively. For esophageal (MA)NEC the median overall survival (OS) after surgery was 37 months and 1-, 3- and 5-year OS were 71%, 50% and 35%, respectively. For gastric (MA)NEC, the median OS was 23 months and 1-, 3- and 5-year OS were 62%, 50% and 39%, respectively. Conclusion: Localized esophageal and gastric (MA)NEC are often misdiagnosed on endoscopic biopsies. After resection, long-term survival was achieved in respectively 35% and 39% of patients.

AB - Introduction: The aim of this study is to provide insight in accuracy of diagnosing, current treatment and survival in patients with resectable esophageal and gastric neuroendocrine- and mixed adenoneuroendocrine carcinomas (NEC, MANEC). Methods: All patients with esophageal or gastric (MA)NEC, who underwent surgical resection between 2006 and 2016, were identified from the Dutch national registry for histo- and cytopathology (PALGA). Patients with a neuroendocrine tumor lower than grade 3 were excluded. Data on patients, treatment and outcomes were retrieved from the patient records. Diagnosis by endoscopic biopsy was compared with diagnosis by resection specimen. Kaplan Meier survival analysis was performed. Results: A total of 49 patients were identified in 25 hospitals, including 21 patients with esophageal (MA)NEC and 26 patients with gastric (MA)NEC on resection specimen. Biopsy diagnosis of (MA)NEC was correct in 23/27 patients. However, 20/47 patients with definitive diagnosis of (MA)NEC, were misdiagnosed on biopsy. Neoadjuvant therapy was administered in 13 (62%) esophageal (MA)NECs and 12 (46%) gastric (MA)NECs. Survival curves were similar with and without neoadjuvant therapy. One (4.8%) esophageal (MA)NEC and 4 (15%) gastric (MA)NECs died within 90 days postoperatively. For esophageal (MA)NEC the median overall survival (OS) after surgery was 37 months and 1-, 3- and 5-year OS were 71%, 50% and 35%, respectively. For gastric (MA)NEC, the median OS was 23 months and 1-, 3- and 5-year OS were 62%, 50% and 39%, respectively. Conclusion: Localized esophageal and gastric (MA)NEC are often misdiagnosed on endoscopic biopsies. After resection, long-term survival was achieved in respectively 35% and 39% of patients.

KW - Biopsy diagnosis

KW - Esophagectomy

KW - Gastrectomy

KW - Mixed adenoneuroendocrine carcinoma

KW - Neoadjuvant therapy

KW - Neuroendocrine carcinoma

KW - Stomach Neoplasms/mortality

KW - Esophageal Neoplasms/mortality

KW - Humans

KW - Middle Aged

KW - Male

KW - Survival Rate

KW - Treatment Outcome

KW - Adenocarcinoma/mortality

KW - Neoplasm Grading

KW - Biopsy

KW - Postoperative Complications/epidemiology

KW - Carcinoma, Neuroendocrine/mortality

KW - Female

KW - Neoadjuvant Therapy

KW - Aged

KW - Netherlands/epidemiology

UR - http://www.scopus.com/inward/record.url?scp=85052947295&partnerID=8YFLogxK

U2 - 10.1016/j.ejso.2018.07.058

DO - 10.1016/j.ejso.2018.07.058

M3 - Article

C2 - 30201419

SN - 0748-7983

VL - 44

SP - 1955

EP - 1962

JO - European Journal of Surgical Oncology

JF - European Journal of Surgical Oncology

IS - 12

ER -

Management of resectable esophageal and gastric (mixed adeno)neuroendocrine carcinoma: A nationwide cohort study

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Keywords

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