Background
Neuroendocrine carcinomas (NECs) arising in the large intestine are rare neoplasms
with highly aggressive behavior. The aim of the study was to compare the 2000 and
2010 World Health Organization (WHO) classification of these colorectal NECs.
Methods
We conducted a retrospective study of patients diagnosed with colorectal NECs according
to the WHO 2000 classification who underwent surgery at the Asan Medical Center between
May 2000 and December 2010. The data were reevaluated to assess their consistency
with the WHO 2010 classification.
Results
For 20 of the 34 patients (59%), the 2000 and 2010 WHO classifications yielded the
same NEC diagnosis (NEC group), whereas for 14 of the 34 patients (41%), the WHO 2010
classification mandated a diagnosis of G1 or G2 neuroendocrine tumors (NETs) rather
than NECs (G1/G2 NET group). The NEC group was older than the G1/G2 NET group (64
vs 55 years; P = .05). Tumor differentiation in the NEC group was poorer than in the G1/G2 NET group
(percentage of poorly differentiated tumor, 70% vs 7%; P < .001). In both groups based on the 7th American Joint Committee on Cancer staging,
most of the tumors were advanced at the time of diagnosis, reaching stage IIIB (6
NEC vs 10 NET) and stage IV (10 NEC vs 3 NET). The 5-year overall survival in the
2 groups was different (P = .02), but not the 5-year disease-free survival (P = .24).
Conclusion
These results indicate that the WHO 2010 classification of colorectal NEC is more
accurate and has better prognostic value than the WHO 2000 classification.
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Article info
Publication history
Published online: November 25, 2013
Accepted:
November 15,
2013
Identification
Copyright
© 2014 Mosby, Inc. Published by Elsevier Inc. All rights reserved.
