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Journal of Gastrointestinal Surgery

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01-05-2014 | Original Article

Prognostic Significance of Neuroendocrine Differentiation in Colorectal Adenocarcinoma After Radical Operation: a Meta-analysis

Authors: Yu-Jie Zeng, Wei Lai, Lu Liu, Heng Wu, Xing-Xi Luo, Jie Wang, Zhong-Hua Chu

Published in: Journal of Gastrointestinal Surgery | Issue 5/2014

Abstract

Background

The phenomenon of neuroendocrine differentiation has been observed in colorectal adenocarcinoma. However, the ability of neuroendocrine differentiation to predict the outcome of colorectal adenocarcinoma remains controversial.

Methods

We conducted an extensive search of research studies related to neuroendocrine differentiation using scientific databases, including the PubMed, Embase, OVID, BIOSIS Previews, and Cochrane Central Register of Controlled Trials (up to July, 2013), according to the established search terms. RevMan version 5.2 statistical program was used to analyze the data. An odds ratio (OR) with a 95 % confidence interval (CI) was used for the dichotomous data.

Results

Eleven studies with a total of 1,587 patients were included. Patients with neuroendocrine differentiation who underwent a radical operation had a lower 5-year survival rate (pooled OR 0.60, 95 % CI 0.37–0.97) compared with those without neuroendocrine differentiation, with evidence of moderate heterogeneity (I ² = 37 %, p = 0.10). A sensitivity analysis and meta-regression showed that the different classification criteria of neuroendocrine differentiation used in these studies were the main source of heterogeneity. When the strong positive rates of neuroendocrine differentiation indicators between the higher (stage III + IV) and the lower (stage I + II) clinical stages were compared, the pooled OR was 1.84 (703 patients; 95 % CI 0.98–3.43) without evidence of heterogeneity (I ² = 0 %, p = 0.89). However, comparisons between consecutive stages showed different ORs: stage II vs. I (203 patients; OR = 0.52, 95 % CI 0.17–1.56), stage III vs. II (569 patients; OR = 2.27, 95 % CI 1.03–4.98), and stage IV vs. III (375 patients; OR = 1.81, 95 % CI 1.00–3.29).

Conclusion

The patients with strong positive indicators of neuroendocrine differentiation had a lower 5-year survival rate. The ability to detect neuroendocrine indicators using conventional methods could improve the prognosis judgment of colorectal adenocarcinoma.

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Title: Prognostic Significance of Neuroendocrine Differentiation in Colorectal Adenocarcinoma After Radical Operation: a Meta-analysis
Authors: Yu-Jie Zeng
Wei Lai
Lu Liu
Heng Wu
Xing-Xi Luo
Jie Wang
Zhong-Hua Chu
Publication date: 01-05-2014
Publisher: Springer US
Published in: Journal of Gastrointestinal Surgery / Issue 5/2014
Print ISSN: 1091-255X
Electronic ISSN: 1873-4626
DOI: https://doi.org/10.1007/s11605-014-2480-x

At a glance: The STEP trials

Springer Medicine

Prognostic Significance of Neuroendocrine Differentiation in Colorectal Adenocarcinoma After Radical Operation: a Meta-analysis

Abstract

Background

Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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