Survival and Incidence Patterns of Pancreatic Neuroendocrine Tumors Over the Last 2 Decades: A SEER Database Analysis

Abstract

Background Pancreatic neuroendocrine tumors (pNETs) are rare cancers with outcomes determined by multiple factors including grade, stage, and clinical presentation. In this study, we aimed to determine the prognosis of patients with pNETs using a large population-based database. Materials and Methods In this population-based study, we identified patients with pNETs from the SEER 18 registry (2000-2016) using a combination of ICD-O-3 and histology codes. We calculated age-adjusted incidence rates using SEER*Stat 8.3.5. In addition, we analyzed overall survival (OS) using the Kaplan-Meier method, and investigated prognostic factors using a multivariable Cox proportional hazards model. Results A total of 8944 pNETs patients were identified. Annual incidence rates increased from 0.27 to 1.00 per 100 000. This was largely explained by an increase in number of patients diagnosed with localized disease in more recent years (2012-2016). Median OS was 68 months (95% CI [64, 73]) and 5-year OS rates in localized, regional, and metastatic disease were 83%, 67%, and 28%, respectively. There was a significant improvement in OS for patients diagnosed between 2009 and 2016 (median OS 85 months) compared with those diagnosed between 2000 and 2008 (median OS 46 months) (HR 0.66; 95% CI [0.62, 0.70]). This improvement in OS was consistent across all stages. Conclusions and Relevance This study shows a steady increase pNETs incidence with notable stage migration to earlier stages in recent years. This increase in incidence is accompanied by a significant improvement in survival across different disease stages.

Recurrence and outcomes of non‐functional pancreatic neuroendocrine tumours post‐resection: an Australian retrospective, multicentre cohort study

“…Consistent with international databases and other large independent trials, the incidence of PNETs have gradually increased over the past decade. 19 One explanation for this would be the increased usage of endoscopic and cross-sectional imaging techniques and increased physician awareness, leading to more diagnoses.…”

“…The median length of hospital stay was 10 days. Forty-four patients required ICU admission post-operatively with a median length of stay of 2 days (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19).…”

Evaluation of Survival Following Surgical Resection for Small Nonfunctional Pancreatic Neuroendocrine Tumors

“…Pancreatic neuroendocrine neoplasm (PanNEN) was renamed and differentiated from carcinoid tumor by the World Health Organization (WHO) in 2000 . Due to greater awareness of PanNENs and the progressive development of imaging modalities, the incidence of PanNENs (including nonfunctional PanNENs [NF-PanNENs]) in the US increased between 2000 and 2016 from 0.27 to 1.00 per 100 000 cases annually . Pancreatic neuroendocrine neoplasms have varying rates of malignancy, and the WHO grading classification was revised in 2010 and 2017 .…”

Safety and Outcomes of Combined Pancreatic and Hepatic Resections for Metastatic Pancreatic Neuroendocrine Tumors

“…1,2 Although pNETs usually exhibit more indolent behavior than pancreatic adenocarcinoma, distant metastases are evident in 40-50% of patients at the time of initial diagnosis. 2,3 The presence of distant metastases is one of the strongest predictors of poor prognosis, with an overall 5-year survival of approximately 20-40% in this group. [4][5][6] Interestingly, even in the presence of distant metastases, primary tumor resection has been associated with a possible survival benefit.…”

“…Pancreatic neuroendocrine tumors (pNETs) are rare tumors, representing only about 1–2% of pancreatic malignancies, but their incidence has significantly increased in the last few decades, particularly for smaller early stage tumors. 1 , 2 Although pNETs usually exhibit more indolent behavior than pancreatic adenocarcinoma, distant metastases are evident in 40–50% of patients at the time of initial diagnosis. 2 , 3 The presence of distant metastases is one of the strongest predictors of poor prognosis, with an overall 5-year survival of approximately 20–40% in this group.…”