Clinical characteristics and prognostic factors of primary hepatic neuroendocrine tumor: a study of 21 patients

Abstract

Objective To analyze the clinical characteristics, diagnosis, treatment and prognostic factors of primary hepatic neuroendocrine tumor (PHNET). Methods To analyze the clinical data of 21 patients with PHNET who were admitted to the First Affiliated Hospital of Zhengzhou University from January 2012 to January 2019. There were 11 males and 10 females, with ages which ranged from 36 to 75 years. Log-rank test was used for single-factor analysis of the relationship between clinical and pathological indicators and prognosis. Cox proportional risk model was used for multi-factor analysis. Results Among the 21 PHNET patients, 10 presented with central and upper abdominal pain, 3 abdominal pain accompanied by nausea and vomiting, 5 abdominal distension, and 3 were asymptomatic. Carbohydrate antigen (CA) 19-9 was elevated in 6 patients and CA125 in 7 patients. Abdominal enhanced CT showed solid liver space occupying lesions. Four patients had solitary and 17 had multiple lesions. The mean diameter was 58 mm. Fourteen patients had lymph node metastasis. Five patients underwent radical hepatectomy, 2 transcatheter hepatic arterial chemoembolization + chemotherapy, 12 chemotherapy, and 2 supportive treatment. Factors which were associated with prognosis of PHNET patients were surgery, tumor grading, cytokeratin positivity and lymph node metastasis. Multivariate Cox regression analysis showed that inoperability (HR=8.99, 95%CI: 1.13-71.80) was an independent risk factor of prognosis of PHNET patients. The prognosis in patients who underwent surgical resection was better. Conclusion Patients with PHNET had no specific clinical manifestations. Surgical resection gave the best results in treatment. As surgical resection affected prognosis, it should be carried out if technically feasible. Key words: Diagnosis; Primary liver neuroendocrine tumor; Clinical characteristics; Influencing factor