Primary Tumor Surgery Improves Survival in Patients With Gastroenteropancreatic Neuroendocrine Carcinoma: A Population-Based Preliminary Study

Background: Chemotherapy has always been the primary treatment for gastroenteropancreatic neuroendocrine carcinomas (GEP-NECs), but the efficacy of surgical resection for GEP-NECs patients receiving chemotherapy is still controversial. Methods: : Information on GEP-NECs patients from 2004 to 2015 were extracted from the Surveillance, Epidemiology, and End Results (SEER) databases. Kaplan-Meier analysis and Log-rank test were used to evaluate the difference in survival rate between the surgery and the non-surgery group. Cox proportional hazard model was used to find the prognostic factors affecting overall survival (OS) time and cancer-specific survival (CSS) time. Results: : A total of 589 patients participated in our study, including 196 patients who underwent surgery and 393 patients who did not undergo surgery. Kaplan-Meier curve showed that there were significant differences in OS and CSS (p<0.001) between the surgery and the non-surgery group. Multivariate COX analysis showed that surgery was an independent protective factor for prolonging the duration of OS and CSS (p < 0.001). At the same time, through the propensity score-matched (PSM) of the original data, we also draw the same conclusion. Conclusion: Our study preliminarily shows that for some patients with GEP-NECs, surgery for primary tumors may bring survival benefits. Compared with chemotherapy alone, surgery combined with chemotherapy can significantly prolong the survival time of patients.