Abstract: Objective  To explore the clinicopathological characteristics and the risk factors in postoperative recurrence of type Ⅳ GNENs. Methods  According to  GNENs pathological grading standard proposed by  World Health Organization in 2010, 69 patients with type Ⅳ GNENs were divided into GNEC group and GMANEC group. The clinicopathological characteristics and risk factors affecting postoperative recurrence of these two groups were analyzed. Results  Type Ⅳ GNENs were more common in middleaged and old men, and the symptoms at the first diagnosis were not typical. There was no statistically significant difference in the clinicopathological characteristics between GNEC and GMANEC group (P>0.05). GMANEC group was less prone to recurrence after operation than GNEC group, and the patients with adjuvant chemotherapy had better prognosis than those without chemotherapy. In patients with type Ⅳ GNENs and GMANEC, the use of EP regimen or SOX regimen for adjuvant chemotherapy had no statistically significant effect on postoperative recurrence (P>0.05). Conclusion  The clinical manifestations of patients with type Ⅳ GNENs are not typical. The clinicopathological characteristics of GNEC and GMANEC are similar. GMANEC patients have better prognosis than GNEC patients. Adjuvant chemotherapy can improve the prognosis of patients with type Ⅳ GNENs. The effects of adjuvant chemotherapy using EP or SOX regimen have no significant difference in the prognosis of patients with type Ⅳ GNENs and GMANEC.

Key words: stomach neoplasms, neuroendocrine tumors, recurrence