Prognostic Factors in Upper Gastrointestinal Neuroendocrine Carcinoma: A Retrospective Cohort Study of Clinicopathological Features and Survival Outcomes

Erdoğan Şeyran, Azer GökmenDepartment of Medical Oncology, Van Training and Research Hospital, Van, TurkeyCorrespondence: Erdoğan Şeyran, Department of Medical Oncology, Van Training and Research Hospital, Van, Turkey, Email [email protected]: Upper gastrointestinal neuroendocrine carcinoma (NEC) is a rare and highly aggressive malignancy with limited prognostic data. This study aimed to evaluate clinicopathological characteristics and to identify clinically relevant prognostic factors, with a particular focus on simple and readily available inflammatory and nutritional biomarkers that may support routine risk stratification.Methods: In this retrospective cohort study, 54 patients with histologically confirmed esophageal or gastric NEC were analyzed. Clinical, pathological, laboratory, treatment, and survival data were collected. Overall survival (OS) was assessed using Kaplan–Meier analysis. Prognostic factors were evaluated using univariate and multivariate Cox proportional hazards models.Results: The median OS was 17.9 months. On univariate analysis, metastatic disease, elevated LDH, elevated neutrophil-to-lymphocyte ratio (NLR), hypoalbuminemia, surgical resection, and adjuvant chemotherapy were significantly associated with OS. In multivariate analysis, hypoalbuminemia remained the only independent predictor of worse survival (HR 2.876, 95% CI 1.116– 7.414; p = 0.029).Conclusion: Hypoalbuminemia emerged as a potential independent prognostic factor in this cohort and may serve as a simple and readily available marker of poor outcome. Albumin, LDH, and NLR may provide additional prognostic information in patients with upper gastrointestinal neuroendocrine carcinoma. However, these findings should be considered exploratory and require validation in larger prospective multicenter studies.Keywords: albumin, inflammation, lactate dehydrogenase, neutrophil-to-lymphocyte ratio, nutritional status, overall survival, prognosis, upper gastrointestinal neuroendocrine carcinoma