Epidemiology, treatment and outcomes of gastroenteropancreatic neuroendocrine neoplasms

Abstract To investigate incidence, treatment patterns and outcomes of gastroenteropancreatic neuroendocrine neoplasms (GEP-NEN) in the United States. The 2019 National Cancer Database was searched for adult GEP-NEN patients. Main outcomes included overall and site-specific incidence, treatment patte...

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Main Authors: Johannes Uhlig, James Nie, Joanna Gibson, Michael Cecchini, Stacey Stein, Jill Lacy, Pamela Kunz, Hyun S. Kim
Format: Article
Language:English
Published: Nature Portfolio 2024-12-01
Series:Scientific Reports
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Online Access:https://doi.org/10.1038/s41598-024-81518-4
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author Johannes Uhlig
James Nie
Joanna Gibson
Michael Cecchini
Stacey Stein
Jill Lacy
Pamela Kunz
Hyun S. Kim
author_facet Johannes Uhlig
James Nie
Joanna Gibson
Michael Cecchini
Stacey Stein
Jill Lacy
Pamela Kunz
Hyun S. Kim
author_sort Johannes Uhlig
collection DOAJ
description Abstract To investigate incidence, treatment patterns and outcomes of gastroenteropancreatic neuroendocrine neoplasms (GEP-NEN) in the United States. The 2019 National Cancer Database was searched for adult GEP-NEN patients. Main outcomes included overall and site-specific incidence, treatment patterns, and overall survival (OS). Overall survival was evaluated using averaged Cox regression. 86,324 GEP-NEN patients were included (6.33% of all GEP malignancies). From 2004 to 2016, annual GEP-NEN cases increased (n = 4,010 to n = 9,379), largely driven by low-stage, low-grade disease. Most patients received surgery, either alone (72.9%) or in combination with systemic therapy (4.9%). Longest overall survival (OS) was evident in patients with low stage and low grade GEP-NEN of the small intestine and rectum (p < 0.001). Patients undergoing surgical resection demonstrated longest OS. The addition of systemic therapy was most effective in high stage G3 NEN. Having higher income (≥$63,333) and private insurance or Medicare, but not Medicaid, was associated with improved survival. GEP-NEN incidence increases, likely due to improved detection and diagnosis. Treatment patterns have evolved to follow the latest international guidelines and site-specific improvement in survival is noted. In addition to disease specific factors, insurance access and socioeconomic factors emerged as potential targets for improving outcomes.
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spelling doaj-art-ce7ff23d4cb24f399d2cf1993e88d0142025-08-20T01:57:09ZengNature PortfolioScientific Reports2045-23222024-12-0114111210.1038/s41598-024-81518-4Epidemiology, treatment and outcomes of gastroenteropancreatic neuroendocrine neoplasmsJohannes Uhlig0James Nie1Joanna Gibson2Michael Cecchini3Stacey Stein4Jill Lacy5Pamela Kunz6Hyun S. Kim7Division of Vascular and Interventional Radiology, Department of Diagnostic Radiology and Nuclear Medicine, University of MarylandSection of Interventional Radiology, Department of Radiology and Biomedical Imaging, Yale School of MedicineDepartment of Pathology, Yale School of Medicine, Yale New Haven HospitalSection of Medical Oncology, Department of Medicine, Yale School of MedicineSection of Medical Oncology, Department of Medicine, Yale School of MedicineSection of Medical Oncology, Department of Medicine, Yale School of MedicineSection of Medical Oncology, Department of Medicine, Yale School of MedicineDivision of Vascular and Interventional Radiology, Department of Diagnostic Radiology and Nuclear Medicine, University of MarylandAbstract To investigate incidence, treatment patterns and outcomes of gastroenteropancreatic neuroendocrine neoplasms (GEP-NEN) in the United States. The 2019 National Cancer Database was searched for adult GEP-NEN patients. Main outcomes included overall and site-specific incidence, treatment patterns, and overall survival (OS). Overall survival was evaluated using averaged Cox regression. 86,324 GEP-NEN patients were included (6.33% of all GEP malignancies). From 2004 to 2016, annual GEP-NEN cases increased (n = 4,010 to n = 9,379), largely driven by low-stage, low-grade disease. Most patients received surgery, either alone (72.9%) or in combination with systemic therapy (4.9%). Longest overall survival (OS) was evident in patients with low stage and low grade GEP-NEN of the small intestine and rectum (p < 0.001). Patients undergoing surgical resection demonstrated longest OS. The addition of systemic therapy was most effective in high stage G3 NEN. Having higher income (≥$63,333) and private insurance or Medicare, but not Medicaid, was associated with improved survival. GEP-NEN incidence increases, likely due to improved detection and diagnosis. Treatment patterns have evolved to follow the latest international guidelines and site-specific improvement in survival is noted. In addition to disease specific factors, insurance access and socioeconomic factors emerged as potential targets for improving outcomes.https://doi.org/10.1038/s41598-024-81518-4Neuroendocrine tumorsIncidenceSurvival
spellingShingle Johannes Uhlig
James Nie
Joanna Gibson
Michael Cecchini
Stacey Stein
Jill Lacy
Pamela Kunz
Hyun S. Kim
Epidemiology, treatment and outcomes of gastroenteropancreatic neuroendocrine neoplasms
Scientific Reports
Neuroendocrine tumors
Incidence
Survival
title Epidemiology, treatment and outcomes of gastroenteropancreatic neuroendocrine neoplasms
title_full Epidemiology, treatment and outcomes of gastroenteropancreatic neuroendocrine neoplasms
title_fullStr Epidemiology, treatment and outcomes of gastroenteropancreatic neuroendocrine neoplasms
title_full_unstemmed Epidemiology, treatment and outcomes of gastroenteropancreatic neuroendocrine neoplasms
title_short Epidemiology, treatment and outcomes of gastroenteropancreatic neuroendocrine neoplasms
title_sort epidemiology treatment and outcomes of gastroenteropancreatic neuroendocrine neoplasms
topic Neuroendocrine tumors
Incidence
Survival
url https://doi.org/10.1038/s41598-024-81518-4
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