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Background: The World Health Organization classifies neuroendocrine neoplasms of the colon and rectun together as a single entity, but there is significant difference observed between them.The prognostic factors of colorectal neuroendocrine neoplasms are still controversial.Design: A total of 68 patients with colorectal neuroendocrine neoplasms (age 20 ~ 82.vears, average age 55.7 years) from March 2001 to March 2014 registered to our center were studied retrospectively.Clinical characteristics and prognosis between the colonic and rectal neuroendocrine neoplasms were compared.Kaplan-Meier method and Cox regression model were used to evaluate the capacity of different factors to predict the outcome.Results: The cohort represented 68 adult patients with colorectal neuroendocrine neoplasms, of whom 43 (63.2%) were rectal neuroendocrine neoplasms, 25 (36.8%) were colonic neuroendocrine neoplasms.Compared to rectal neuroendocrine neoplasms, colonic neuroendocrine neoplasms were easier to present with larger tumor size (P=0.000) and distant metastasis (P=0.000) when diagnosed.The colonic neuroendocrine neoplasms had a worse prognosis (P=0.027), with 5-year overall survival rate of 66.7% vs.88.1%.Based on the 2010 World Health Organization classification, neuroendocrine tumor, neuroendocrine caecinoma and mixed adenoendocrine carcinoma were 61.8%, 23.5% and 14.7%, respectively.According to the available data (n=49), Ki-67 index of 27(39.7%) patients were ≤ 2%, 6 (8.8%) range from 3% to 20% and 16 (23.5%) were >20%.The multivariate analysis showed that the tumor location was not an independent prognostic factor (P=0.081), but tumor size (P=0.037) and tumor classification (P=0.012) were independent prognostic factors.Conclusion: There was significant difference between colonic and rectal neuroendocrine neoplasms.Tumor size and tumor classification were associated to the prognosis.However, tumor location was not an independent factor.The worse prognosis of colonic neuroendocrine neoplasms might be due to the larger tumor size caused by the delayed diagnosis.