胃肠胰神经内分泌癌（GEP-NEC）是一组罕见且具有侵袭性的恶性肿瘤，通常具有广泛的疾病。关于 GEP-NECs 的研究有限，因此，我们的目标是获得更多有关临床特征、治疗方案和预后的信息。数据来自先前未在第一附属医院接受过晚期疾病全身治疗的晚期 GEP-NECs 患者回顾性收集南京医科大学附属医院2010年至2022年的资料。使用Kaplan-Meier曲线和cox回归模型研究临床病理特征、治疗方案和预后之间的关系。共有54名患者参与该研究。中位年龄为 65.5 岁，79.6%为男性。诊断时，分别有51.9%和3.7%的患者出现肝转移和脑转移。 16例（29.6%）患者根据肿瘤原发部位（PST）接受化疗，38例（70.4%）患者在晚期小细胞肺一线治疗的基础上接受依托泊苷-铂（EP）方案治疗癌症（SCLC）。两组之间的无进展生存期（PFS）和缓解率没有显着差异。单变量生存分析显示，肝转移、基线血清癌胚抗原升高、基线血清神经元特异性烯醇化酶升高、基线血清乳酸脱氢酶升高和基线血清中性粒细胞与淋巴细胞比率 (NLR) 升高与较短的 PFS 相关。经过多变量分析，NLR 升高是唯一与较短 PFS 显着相关的因素 (P=0.01)。GEP-NEC 是侵袭性肿瘤，其中 NLR 升高被证明是独立的阴性预测因子。对于 GEP-NEC 患者，基于 PST 的治疗方案并不逊色于基于 SCLC (EP) 的治疗方案。需要进行大规模、前瞻性随机对照试验来建立护理标准。2024 年胃肠肿瘤学杂志。版权所有。

Gastroenteropancreatic neuroendocrine carcinomas (GEP-NECs) constitute a rare and aggressive group of malignancies usually with widespread disease. There are limited studies on GEP-NECs, and therefore, we aim to acquire more information on the clinical features, treatment regimens, and prognosis.Data from advanced GEP-NECs patients who had not previously received systemic treatment for advanced disease at The First Affiliated Hospital of Nanjing Medical University from 2010 to 2022 were retrospectively collected. Relationships between clinical-pathological features, treatment regimens, and prognosis were investigated using Kaplan-Meier curves and cox regression models.A total of fifty-four patients were enrolled in the study. The median age was 65.5 years and 79.6% were male. At diagnosis, 51.9% and 3.7% of patients developed liver and brain metastasis respectively. Sixteen (29.6%) patients received chemotherapy according to primary site of tumor (PST), while thirty-eight (70.4%) were treated with etoposide-platinum (EP) regimen, which based on the first-line treatment of advanced small cell lung cancer (SCLC). No significant differences on progression-free survival (PFS) and response rate were observed between these two groups. Univariate survival analysis showed that liver metastasis, elevated baseline serum carcinoembryonic antigen, elevated baseline serum neuron-specific enolase, elevated baseline serum lactate dehydrogenase, and elevated baseline serum neutrophil-to-lymphocyte ratio (NLR) were associated with shorter PFS. After multivariate analysis, elevated NLR was the only factor that remained significantly associated with shorter PFS (P=0.01).GEP-NECs are aggressive neoplasms, of which elevated NLR is proven to be an independent negative predictor. Treatment regimens based on PST are not inferior to regiments based on SCLC (EP) for GEP-NECs patients. Large-scale, prospective randomized controlled trials are required to establish the standard of care.2024 Journal of Gastrointestinal Oncology. All rights reserved.