@article{article_1744286, title={Investigation of systemic treatment responses and prognostic factors in metastatic gastroenteropancreatic neuroendocrine carcinomas (GEP-NECs)}, journal={Journal of Health Sciences and Medicine}, volume={8}, pages={959–965}, year={2025}, DOI={10.32322/jhsm.1744286}, author={Türkel, Alper and Ercan Uzundal, Duygu and Gürler, Fatih and Deliktaş Onur, İlknur and Gülcü, Serkan and Yalçıntaş Arslan, Ülkü}, keywords={Ekstrapulmoner, Nöroendokrin karsinom, GEP-NEC, NLR}, abstract={Aims: This study aimed to evaluate responses to first- and second-line treatments, survival outcomes, and potential factors affecting survival in patients with metastatic gastroenteropancreatic neuroendocrine carcinoma (GEP-NEC). Methods: This retrospective study included 42 patients with metastatic GEP-NEC from three centers. First and second-line chemotherapy regimens were examined. The median progression-free survival (mPFS1 and mPFS2) for first and second-line treatments and overall survival (mOS) were evaluated. The effects of CRP levels, LDH levels, neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR) on survival were investigated as potential prognostic factors. Results: Median follow-up was 15 months (3-113). mPFS1 was 5 months (95% CI: 2.88-7.11) and mPFS2 was 2 months (95% CI: 1.67-2.32). The mOS was 15 months (95% CI: 10.90-19.09). Curative surgery patients had a 28-month mOS, and patients who could not undergo surgery had a mOS of 14 months (p=0.010). Patients with NLR <2.56 had a longer mOS (22 months vs. 14 months, p=0.019) than those with NLR ≥2.56. Multivariate analysis showed that lower NLR scores and Ki67 values were associated with longer mOS [HR: 0.38 (95% CI: 0.18-0.79), p=0.010 and HR: 0.41 (95% CI: 0.20-0.84), p=0.015] Conclusion: Our study showed that higher NLR scores and Ki67 values significantly worsened mOS. Survival outcomes (OS, PFS1, and PFS2) aligned with the literature. NECs need new treatments and prognostic markers due to their poor prognosis, short survival times, and lack of standard guidelines.}, number={6}, publisher={MediHealth Academy Yayıncılık}