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GI Neuroendocrine Tumors Increasing in Incidence
Gastroenteropancreatic (GEP) neuroendocrine tumors (NETs) are a rare, heterogenous group of diseases with a natural history ranging from indolent to highly aggressive. There is evidence of increased incidence of these tumors from recent retrospective series. Investigators now report a cohort study evaluating epidemiologic and survival data in nearly 44,000 patients with GEP NETs from 1975 to 2015 from the U.S. Surveillance, Epidemiology, and End Results (SEER) Program.
Incidence was similar in men and women, with age-adjusted incidence rates increasing over time. Rates increased similarly across races and some ethnicities but were more stable in American Indian and Alaska natives. Rates of increase were highest for localized and for grade 1 NETs, and rectal and small bowel tumors had the highest prevalence. Mean age at diagnosis for localized disease increased by 9 years over the study period.
Median overall survival (OS) was as follows:
- Superior for rectal and appendiceal primaries (not reached) compared to pancreatic primaries (67 months).
- Inferior in patients aged 60 or older (262 months) compared to younger patients (not reached).
- Superior for localized tumors (not reached) compared with regional tumors (297 months)
- Markedly inferior for grade 3–4 tumors (9–11 months) compared with grade 1–2 tumors (not reached).
- In patients with distant disease, superior for NETs of the small intestine (96 months) compared to the colon (8 months), stomach (9 months), and rectum (11 months).
In a nomogram generated to predict OS, factors with the greatest impact were tumor grade followed by tumor primary site, age, and tumor size.
Comment
This large series supports the observation of an increased incidence of GEP NETs. An increase in diagnosis may result from increasing use of cross-sectional imaging, and overall survival may continue to improve with the advent of more effective systemic and regional therapies.
Citation(s)
Author:
Xu Z et al.
Title:
Epidemiologic trends of and factors associated with overall survival for patients with gastroenteropancreatic neuroendocrine tumors in the United States.
Source:
JAMA Netw Open
2021
Sep
23; [e-pub].
(Abstract/FREE Full Text)
Empfohlen von
David H. Ilson, MD, PhD