Neuroendocrine neoplasms (NENs) display variable behaviors based on origin and grade. We assumed that both tumor origin and the location of metastasis may play a role in survival. We queried the SEER database (2010–2014) for patients with an established diagnosis of NENs and documented site of metastasis and identified 2005 patients. Overall survival (OS) at the time points were estimated by the Kaplan-Meier method Cox proportional-hazards models were used to evaluate the relationship of the interested variables and OS. Lung, liver, bone and brain metastases were observed in 9, 77, 7 and 6% of metastatic patients respectively. In the multivariate model, metastasis locations were significantly associated with worse survival (liver HR: 1.677 (1.226–2.294); (bone metastasis HR: 1.412 (0.965–2.065); brain HR: 1.666 (1.177–2.357)). We produced a scoring system based on site of origin, metastasis location, age, gender, histology and tumor size that can stratify metastatic NEN patients in low, intermediate and high-risk categories to help physicians with decision making. Site of metastasis plays an important role in survival of metastatic NEN patients independent of commonly described prognostic factors and should be considered in survival estimates.

中文翻译：

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转移部位对神经内分泌肿瘤（NEN）患者生存的影响。2010-2014年SEER数据分析

神经内分泌肿瘤（NEN）根据起源和级别表现出不同的行为。我们假设肿瘤起源和转移位置都可能在生存中发挥作用。我们在 SEER 数据库（2010-2014 年）中查询了确诊为 NEN 并记录转移部位的患者，并确定了 2005 名患者。通过 Kaplan-Meier 方法估计各时间点的总生存期 (OS)，并使用 Cox 比例风险模型评估感兴趣的变量与 OS 的关系。肺转移、肝转移、骨转移和脑转移的比例分别为 9%、77%、7% 和 6%。在多变量模型中，转移位置与较差的生存率显着相关（肝脏 HR：1.677 (1.226–2.294)；（骨转移 HR：1.412 (0.965–2.065)；脑 HR：1.666 (1.177–2.357)）。基于起源部位、转移部位、年龄、性别、组织学和肿瘤大小的评分系统，可以将转移性 NEN 患者分为低、中和高风险类别，以帮助医生做出决策。转移部位在生存中起着重要作用转移性 NEN 患者的独立性与常见的预后因素无关，应在生存估计中予以考虑。