Clinical features and prognostic factors of duodenal neuroendocrine tumours: A comparative study of ampullary and nonampullary regions

Table 1 Basic information of duodenal neuroendocrine tumour patients, n (%)

Clinical features	Duodenal neuroendocrine tumours (n = 29)
Gender
Males	34.5 (10/29)
Females	65.5 (19/29)
Tumour site
Ampullary region	24.1 (7/29)
Nonampullary region	75.9 (22/29)
Age at diagnosis
Median age (yr)	55.7 ± 10.3
30-39	7.0 (2/29)
40-49	24.1 (7/29)
50-59	34.5 (10/29)
60-69	24.1 (7/29)
≥ 70	10.3 (3/29)
Symptoms
Abdominal pain	51.7 (15/29)
Abdominal distension	17.2 (5/29)
Acid reflux	17.2 (5/29)
Nausea	13.8 (4/29)
Vomiting	3.4 (1/29)
Black stools	7.0 (2/29)
Poor appetite	7.0 (2/29)
No symptoms	20.7 (6/29)
Tumour size	2.6 ± 1.6 cm
≤ 1 cm	13.8 (4/29)
1-2 cm	20.7 (6/29)
≥ 2 cm	65.5 (19/29)
Histological classification and grading
NET-G1	48.3 (14/29)
NET-G2	44.8 (13/29)
NET-G3	3.4 (1/29)
NEC	3.4 (1/29)
Tumour staging
I	13.8 (4/29)
II	55.2 (16/29)
III	13.8 (4/29)
IV	17.2 (5/29)
Tumour type
Nonfunction	96.6 (28/29)
Function(gastrinoma)	3.4 (1/29)
Surgery
Yes	86.2 (25/29)
No	13.8 (4/29)
Postoperative chemotherapy
Yes	20.7 (6/29)
No	79.3 (23/29)
Survival status
Death	41.4 (12/29)
Survival	58.6 (17/29)

Table 2 Comparison clinical features of duodenal neuroendocrine tumour patients in ampullary region and nonampullary region

Clinical features	Ampullary region (n = 7)	Nonampullary region (n = 22)	Statistical value	P value
Males/females (n/n)	1/6	9/13	Fisher exact test	0.367
Age at diagnosis (yr)	59.256 ± 11.368	54.546 ± 9.99	t = 1.059	0.299
Tumour size (cm)	2.543 ± 1.316	2.696 ± 1.648	t = -0.223	0.826
Survival time (month)	10 (8, 30)	71.5 (35, 123)	Z = -3.238	0.000
Histological classification and grading, n (%)			Fisher exact probability method = 4.098	0.241
NET-G1	2 (28.6)	12 (54.5)
NET-G2	4 (57.1)	9 (41)
NET-G3	1 (14.3)	0 (0)
NEC	0 (0)	1 (4.5)
Tumour staging, n (%)			Fisher exact probability method = 6.996	0.036
I	2 (28.6)	2 (9.1)
II	11 (14.3)	15 (68.2)
III	2 (28.6)	2 (9.1)
IV	2 (28.6)	3 (13.6)
With/without functional tumours (n/n)	1/6	0/22	Fisher exact test	0.241
With/without surgery (n/n)	5/2	20/2	Fisher exact test	0.238
With/without chemotherapy (n/n)	1/6	5/17	Fisher exact test	0.545
Death/survival (n/n)	6/1	6/16	Fisher exact test	0.011

Table 3 Univariate and multivariate analysis of overall survival of duodenal neuroendocrine tumour patients

Factor	Univariate analysis		Multivariate analysis
	HR (95%CI)	P value	HR (95%CI)	P value
Tumour staging	8.000 (5.060-10.940)	0.003		-
Surgery (with/without)	8.000 (6.303-9.697)	0.000	0.029 (0.004-0.199)	0.000
Tumour site (ampullary/nonampullary region)	10.000 (8.829-11.171)	0.000	12.609 (2.889-55.037)	0.001

"-" is not listed as it has no statistical significance.

Table 4 Basic information of nonampullary duodenal neuroendocrine tumours patients, n (%)

Clinical features	Tumour size (diameter)
	< 2 cm (n = 8)	≥ 2 cm (n = 14)
Gender
Males	12.5 (1/8)	57.1 (8/14)
Females	87.5 (7/8)	42.9 (6/14)
Age at diagnosis
Median age (yr)
< 65	75 (6/8)	85.7 (12/14)
≥ 65	25 (2/8)	14.3 (2/14)
Symptoms
Abdominal pain	12.5 (1/8)	57.1 (8/14)
Abdominal distension	12.5 (1/8)	85.7 (12/14)
Acid reflux	25 (2/8)	0 (0/14)
Nausea	0 (0/8)	14.3 (2/14)
Vomiting	0 (0/8)	7.1 (1/14)
Black stools	0 (0/8)	14.3 (2/14)
Poor appetite	0 (0/8)	14.3 (2/14)
No symptoms	50 (4/8)	14.3 (2/14)
Histological classification and grading
NET-G1	62.5 (5/8)	50 (7/14)
NET-G2	25 (2/8)	50 (7/14)
NET-G3	0 (0/8)	0 (0/14)
NEC	12.5 (1/8)	0 (0/14)
Tumour staging
I	25 (2/8)	0 (0/14)
II	75 (6/8)	64.3 (9/14)
III	0 (0/8)	14.3 (2/14)
IV	0 (0/8)	21.4 (3/14)
Surgery
Yes	100 (8/8)	85.7 (12/14)
No	0 (0/8)	14.3 (2/14)
Postoperative chemotherapy
Yes	12.5 (1/8)	28.6 (4/14)
No	87.5 (7/8)	71.4 (10/14)
Survival status
Death	0 (0/8)	42.9 (6/14)
Survival	100 (8/8)	57.1 (8/14)

Table 5 Clinical characteristics comparison of nonampullary duodenal neuroendocrine tumour patients

Clinical features	Tumour size (diameter)		Statistical value	P value
	< 2 cm (n = 8)	≥ 2 cm (n = 14)
Males/females (n/n)	1/7	8/6	Fisher exact test	0.052
Age at diagnosis (yr)	56.50 ± 12.00	53.43 ± 8.97	t = 0.684	0.502
Survival time (month)	191.25 ± 175.47	42.93 ± 30.49	t = 7.243	0.048
Histological classification and grading, n (%)			Fisher exact probability method = 5.090	0.120
NET-G1	5	7
NET-G2	2	7
NET-G3	0	0
NEC	1	0
Tumour staging, n (%)			Fisher exact probability method = 2.459	0.363
I	2	0
II	6	9
III	0	2
IV	0	3
With/without surgery (n/n)	8/8	12/2	Fisher exact test	0.515
With/without chemotherapy (n/n)	1/7	4/10	Fisher exact test	0.394
Death/survival (n/n)	0/8	8/14	Fisher exact test	0.051