Incidence and survival of neuroendocrine neoplasia in England 1995–2018: A retrospective, population-based study

White, Benjamin E; Rous, Brian; Chandrakumaran, Kandiah; Wong, Kaitlyn E.; Bouvier, Catherine; Hemelrijck, Mieke Van; George, Gincy; Russell, Beth; Srirajaskanthan, Rajaventhan; Ramage, John

doi:10.1016/j.lanepe.2022.100510

Cited by 38 publications

(45 citation statements)

References 33 publications

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“…This study demonstrates that females diagnosed with neuroendocrine neoplasia display a survival advantage compared to males. Sex is a statistically significant predictor of survival in multivariable analysis [ 8 ]. The survival advantage for females remained statistically significant when examining the subgroups ( Table 3 ).…”

Section: Discussionmentioning

confidence: 99%

“…The stage at presentation might explain some of the survival differences observed in NEN between males and females. Early-stage appendiceal and lung NEN, for example, occur more frequently in females, whilst late-stage pancreatic and stomach NEN occur more frequently in males [ 8 ]. Mediation analysis can be used to further study the relationship between sex and survival and how this is influenced by the stage [ 43 ].…”

Section: Methodsmentioning

confidence: 99%

“…Survival at each NEN tumour site has improved in England over the last 25 years. This is likely due to a combination of increased detection of low-stage tumours resulting in ‘stage shift’ and the effect of treatment advances [ 8 ]. The predictors of survival at diagnosis of NEN identified so far are age, sex, organ site, stage, grade, deprivation (also known as socio-economic status) and marital status.…”

Section: Introductionmentioning

confidence: 99%

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Sex Differences in Survival from Neuroendocrine Neoplasia in England 2012–2018: A Retrospective, Population-Based Study

White

Russell

Remmers

et al. 2023

Cancers

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Pre-clinical studies have suggested sex hormone signalling pathways may influence tumorigenesis in neuroendocrine neoplasia (NEN). We conducted a retrospective, population-based study to compare overall survival (OS) between males and females with NEN. A total of 14,834 cases of NEN diagnosed between 2012 and 2018, recorded in England’s National Cancer Registry and Analysis Service (NCRAS), were analysed. The primary outcome was OS with 5 years maximum follow-up. Multivariable analysis, restricted mean survival time and mediation analysis were performed. Appendiceal, pulmonary and early-stage NEN were most commonly diagnosed in females; stomach, pancreatic, small intestinal, colonic, rectal and later-stage NEN were more often diagnosed in males. Females displayed increased survival irrespective of the stage, morphology or level of deprivation. On average, they survived 3.62 (95% CI 1.73–5.90) to 10.26 (6.6–14.45) months longer than males; this was statistically significant in NEN of the lung, pancreas, rectum and stomach (p < 0.001). The stage mediated improved survival in stomach, lung, and pancreatic NEN but not in rectal NEN. The reasons underlying these differences are not yet understood. Overall, females diagnosed with NEN tend to survive longer than males, and the stage at presentation only partially explains this. Future research, as well as prognostication and treatment, should consider sex as an important factor.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Sex Differences in Survival from Neuroendocrine Neoplasia in England 2012–2018: A Retrospective, Population-Based Study

White

Russell

Remmers

et al. 2023

Cancers

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“…Encoding of the target variable Even though machine learning models for censored data are evolving, most present predictive models cannot handle censored data [35]. To avoid the problem presented by censored data, we encode the OS in months into an integer value (1)(2)(3)(4)(5)(6). Using 60 months median follow-up time as a reference, there are no censored patients with OS below 60 months.…”

Section: Feature Transformation and Normalizationmentioning

confidence: 99%

“…Gastroenteropancreatic (GEP) neuroendocrine neoplasms (NEN) are heterogeneous types of malignancies increasingly common over the last three decades [1,2]. High-grade GEP NEN encompasses both neuroendocrine tumors grade 3 (NET G3) and neuroendocrine carcinomas (NEC), where NEC is further subdivided into small cell (SC) and large cell carcinomas (LC).…”

Section: Introductionmentioning

confidence: 99%

Towards Understanding the Survival of Patients with High-Grade Gastroenteropancreatic Neuroendocrine Neoplasms: An Investigation of Ensemble Feature Selection in the Prediction of Overall Survival

Jenul¹,

Stokmo²,

Schrunner³

et al. 2023

Preprint

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Determining the most informative features for predicting the overall survival of patients diagnosed with high-grade gastroenteropancreatic neuroendocrine neoplasms is crucial to improve individual treatment plans for patients, as well as the biological understanding of the disease. Recently developed ensemble feature selectors like the Repeated Elastic Net Technique for Feature Selection (RENT) and the User-Guided Bayesian Framework for Feature Selection (UBayFS) allow the user to identify such features in datasets with low sample sizes. While RENT is purely data-driven, UBayFS is capable of integrating expert knowledge a priori in the feature selection process. In this work we compare both feature selectors on a dataset comprising of 63 patients and 134 features from multiple sources, including basic patient characteristics, baseline blood values, tumor histology, imaging, and treatment information. Our experiments involve data-driven and expert-driven setups, as well as combinations of both. We use findings from clinical literature as a source of expert knowledge. Our results demonstrate that both feature selectors allow accurate predictions, and that expert knowledge has a stabilizing effect on the feature set, while the impact on predictive performance is limited. The features WHO Performance Status, Albumin, Platelets, Ki-67, Tumor Morphology, Total MTV, Total TLG, and SUV max are the most stable and predictive features in our study.

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Accuracy of DOTATATE PET imaging in the preoperative planning of small bowel neuroendocrine tumor resection

Zhang,

Gudmundsdottir,

Takahashi

et al. 2023

Journal of Surgical Oncology

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Background and ObjectivesWe assessed the accuracy of preoperative gallium‐68 DOTA‐Tyr3‐octreotate (DOTATATE) positron emission tomography (PET) imaging in estimating multifocality and nodal metastases of small bowel neuroendocrine tumors (sbNETs).MethodsA multicenter analysis was performed on patients with sbNETs who underwent preoperative DOTATATE PET imaging and surgical resection, with manual palpation of the entire length of the small bowel, between January 2016 and August 2022. Preoperative imaging reports and blinded secondary imaging reviews were compared to the final postoperative pathology reports. Descriptive statistics were applied.ResultsOne‐hundred and four patients met inclusion criteria. Pathology showed 53 (51%) patients had multifocal sbNETs and 96 (92%) had nodal metastases. The original preoperative DOTATATE PET imaging identified multifocal sbNET in 28 (27%) patients and lymph node (LN) metastases in 80 (77%) patients. Based on original radiology reports, sensitivity for multifocal sbNET identification was 45%, specificity was 92%, positive predictive value (PPV) was 86%, and negative predictive value (NPV) was 62%. For the identification of LN metastases, sensitivity was 82%, specificity was 88%, PPV was 99%, and NPV was 29%.ConclusionsAlthough DOTATATE PET imaging is specific and relatively accurate, sensitivity and NPV are insufficient to guide surgical planning. Preoperative use should not replace open palpation to identify additional synchronous lesions or to omit regional lymphadenectomy.

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Incidence and survival of neuroendocrine neoplasia in England 1995–2018: A retrospective, population-based study

Cited by 38 publications

References 33 publications

Sex Differences in Survival from Neuroendocrine Neoplasia in England 2012–2018: A Retrospective, Population-Based Study

Sex Differences in Survival from Neuroendocrine Neoplasia in England 2012–2018: A Retrospective, Population-Based Study

Towards Understanding the Survival of Patients with High-Grade Gastroenteropancreatic Neuroendocrine Neoplasms: An Investigation of Ensemble Feature Selection in the Prediction of Overall Survival

Accuracy of DOTATATE PET imaging in the preoperative planning of small bowel neuroendocrine tumor resection

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