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Primary Gallbladder Neuroendocrine Tumors: Insights into a Rare Histology Using a Large National Database

  • Reed I. Ayabe
  • Michael Wach
  • Samantha Ruff
  • Sean Martin
  • Laurence Diggs
  • Timothy Wiemken
  • Leslie Hinyard
  • Jeremy L. Davis
  • Carrie Luu
  • Jonathan M. HernandezEmail author
Endocrine Tumors
  • 12 Downloads

Abstract

Background

Primary gallbladder neuroendocrine tumors (NETs) are rare, poorly understood cancers infrequently encountered at even the largest of tertiary referral centers. We therefore sought to identify a large cohort of patients with gallbladder NETs using a national database, with the aim of defining treatment modalities employed and survival associated with these uncommon malignancies.

Methods

Patients with primary gallbladder NETs were identified in the National Cancer Database, and clinicopathologic characteristics were recorded. A univariate log-rank survival analysis was completed for patients who underwent resection. Parameters found to be significant were entered into a multivariate accelerated failure time analysis. For context, survival comparisons were included for patients who underwent resections for NETs at any gastrointestinal site and for gallbladder adenocarcinoma.

Results

Overall, 754 patients with gallbladder NETs were identified. Patients were predominantly female (n = 518, 69%), White (n = 503, 67%), presented with stage IV disease (n = 295, 39%) and had high-grade lesions (n = 312, 41%). The majority underwent resection (n = 480, 64%), primarily simple cholecystectomy (n = 431, 90%), whereas a minority received multimodal therapy (n = 145, 21%). Among patients who underwent resection, older age (p = 0.001), large cell histology (p = 0.012), and positive margins (p = 0.030) were independently associated with worse overall survival. Patients with gallbladder NETs had improved survival relative to those with gallbladder adenocarcinoma (p = 0.001), but significantly worse survival than patients with NETs from other gastrointestinal sites (p < 0.001).

Conclusions

Primary gallbladder NETs are aggressive lesions that carry a worse prognosis than NETs of other gastrointestinal sites. Older age, positive margins, and large cell histology are associated with abbreviated survival after resection.

Notes

Funding

This research did not receive any specific grants from funding agencies in the public, commercial, or not-for-profit sectors.

Supplementary material

10434_2019_7440_MOESM1_ESM.docx (207 kb)
Supplementary material 1 (DOCX 208 kb)

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Copyright information

© Society of Surgical Oncology 2019

Authors and Affiliations

  • Reed I. Ayabe
    • 1
  • Michael Wach
    • 1
  • Samantha Ruff
    • 1
  • Sean Martin
    • 1
  • Laurence Diggs
    • 2
  • Timothy Wiemken
    • 3
  • Leslie Hinyard
    • 3
  • Jeremy L. Davis
    • 1
  • Carrie Luu
    • 2
  • Jonathan M. Hernandez
    • 1
    Email author
  1. 1.Surgical Oncology ProgramNational Cancer Institute, National Institutes of HealthBethesdaUSA
  2. 2.Division of General Surgery, Department of SurgerySaint Louis University HospitalSt. LouisUSA
  3. 3.Saint Louis University Center for Health Outcomes Research (SLUCOR)St. LouisUSA

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