Gastric Neuroendocrine Tumors (G-Nets): Incidence, Prognosis and Recent Trend Toward Improved Survival

Abstract

Background/Aims: Gastric neuroendocrine tumors (G-NETs) are uncommon neoplasms that can present with or without clinical symptoms. In this study, we evaluated the incidence, prognosis, and temporal trends of G-NETs. Methods: We analyzed all cases of G-NETs registered in the Surveillance, Epidemiology, and End Results (SEER) database from 1973 to 2014. Incidence was estimated by age and joinpoint analyses. Survival rates were calculated and survival trends over time were evaluated. Results: A total of 3740 eligible patients were enrolled in the study. G-NETs incidence increased from 0.31 per 1 000 000 patients in 1975 to 4.85 in 2014, with an annual percentage changes (APCs) of 8.9% (95% confidence interval [CI] = 7.7% to 10.21%, P < 0.001, t test (29) from 1975 to 2001 and 3.6% from 2002 to 2014 (95% CI= 2.3% to 4.9%, P < 0.001). For cases diagnosed between 1973 and 1982, five-year survival was 62.8% ± 7.0% (Standard error, SE) and increased to 86.7% ± 0.7% for cases diagnosed between 2003 and 2012 (P < 0.001). Years of diagnosis, gender, age at diagnosis, marital status, grade, tumor size, tumor stage, and surgery performed or not were the strongest predictors of worse survival in both univariate and multivariate analysis (P<0.05). Conclusion: G-NETs are uncommon neoplasms but the incidence is growing. Survival has improved in the past decades. Years of diagnosis, gender, age at diagnosis, marital status, grade, tumor size, tumor stage, and surgery status predict survival in patients with G-NETs.

Trends of incidence and prognosis of gastric neuroendocrine neoplasms: a study based on SEER and our multicenter research

“…GNENs were an orphan disease and accounted for 6.9% of all the GEP-NENs, representing 0.3-1.8% of all gastric malignancies [17][18][19]. Based on the up-to-date SEER database, our study revealed that the incidence of GNENs has increased gradually in the past 4 decades, consisting with the previous study [1,2,17]. Moreover, it was rapidly increased among those with localized and grade I tumors.…”

“…The incidence of NENs has increased to 6.98/100,000 [1] in 2012 according to the data of Surveillance, Epidemiology and End Results (SEER) database. The increase could be observed among NENs at all sites, especially in gastric NENs (GNENs) with nearly 15-fold in the past 40 years [1], reaching up to 4.85/1,000,000 in 2014 [2]. According to WHO classification of 2010, NENs have been divided into well-differentiated neuroendocrine tumor (NET) and poorly differentiated neuroendocrine carcinoma (NEC) [3].…”

Well Differentiated Neuro-Endocrine Tumor of the Stomach: A Case Report

“…Various factors had been identified to assess the prognosis of these cases like duration, sex, age group, size, site, grading and staging and other factors. These variables affect the outcome of disease in terms of morbidity and mortality 19 . There were no current or past researches available in the form of randomized control or retrospective studies available on GNET in Pakistan.…”

What is New in the 2019 World Health Organization (WHO) Classification of Tumors of the Digestive System: Review of Selected Updates on Neuroendocrine Neoplasms, Appendiceal Tumors, and Molecular Testing

“…One study showed an increased incidence of gastric neuroendocrine tumors from 0.31 per 1 000 000 patients in 1975 to 4.85 in 2014. 27 Gastric NETs have a site-specific distribution depending on the tumor subtype. For example, histamine-producing enterochromaffin-like (ECL) cell NETs arise in the corpus/ fundus while somatostatin-expressing D-cell and gastrinexpressing G-cell NETs occur in the antrum.…”