Epidemiologic trends in neuroendocrine tumors: An examination of incidence rates and survival of specific patient subgroups over the past 20 years

Elderly Patients with Metastatic Neuroendocrine Tumors Are Undertreated and Have Shorter Survival: The LyREMeNET Study

“…The baseline characteristics of mNET patients were consistent with those previously reported; the majority of patients had a primary tumor in the small intestine or pancreas, a nonfunctioning tumor, and liver metastases [2]. Interestingly, although no significant difference was found herein when stratifying by age, it has recently been reported using results from the SEER database that the frequency of distant metastatic disease at diagnosis decreases in function of younger age (from 34% at age > 70 years to 11% at age ≤20 years), as does the frequency of grade 3 tumors (from 41% at age > 70 years to 16% at age ≤20 years) [2]. However, it should be noted that the SEER database also included poorly differentiated neuroendocrine carcinoma in the grade 3 category [2], which was not the case herein.…”

“…Interestingly, although no significant difference was found herein when stratifying by age, it has recently been reported using results from the SEER database that the frequency of distant metastatic disease at diagnosis decreases in function of younger age (from 34% at age > 70 years to 11% at age ≤20 years), as does the frequency of grade 3 tumors (from 41% at age > 70 years to 16% at age ≤20 years) [2]. However, it should be noted that the SEER database also included poorly differentiated neuroendocrine carcinoma in the grade 3 category [2], which was not the case herein. To the best of our knowledge, the present study is the first to report that elderly mNET patients were undertreated compared to patients < 70 years old, which could, at least in part, explain the poorer prognosis reported both herein and elsewhere for NET [2,4].…”

“…However, it should be noted that the SEER database also included poorly differentiated neuroendocrine carcinoma in the grade 3 category [2], which was not the case herein. To the best of our knowledge, the present study is the first to report that elderly mNET patients were undertreated compared to patients < 70 years old, which could, at least in part, explain the poorer prognosis reported both herein and elsewhere for NET [2,4]. These results are also consistent with previously published studies in other types of cancer that report that elderly patients are likely to be undertreated [6][7][8][9].…”

“…Their incidence is rising and, interestingly, the most important rise was noted in the population aged > 65 years, among whom the incidence is estimated to be 25.3 per 100,000 person-years [1]. The median age of patients at diagnosis is 63.0 years [2], and a European register reported in 2010 that about 25% of NETs patients were > 75 years old [3]. Moreover, recent results from the Surveillance, Epidemiology, and End Results (SEER) program [2] and from a Norwegian population-based study regarding the NET population showed that the median overall survival (OS) decreased with age, but the type of death was not reported [4].…”

“…The median age of patients at diagnosis is 63.0 years [2], and a European register reported in 2010 that about 25% of NETs patients were > 75 years old [3]. Moreover, recent results from the Surveillance, Epidemiology, and End Results (SEER) program [2] and from a Norwegian population-based study regarding the NET population showed that the median overall survival (OS) decreased with age, but the type of death was not reported [4]. However, we do not know whether patients die as a consequence of disease progression (suboptimal treatment or more aggressive disease) or due to comorbidities.…”