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Survival over two decades in neuroendocrine neoplasms care
Julie Hallet1,2,3,4, Léamarie Meloche-Dumas2, Carlotta Sarzo5
1Susan Leslie Clinic for Neuroendocrine Tumors, Odette Cancer Centre - Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.
Background:
The incidence of gastro-entero-pancreatic neuroendocrine neoplasms (GEP-NENs) has increased, alongside novel therapies and care models. Whether these advances translated into improved survival is unclear.
Methods:
Population-based retrospective cohort study of GEP-NENs between 2000-2019. Overall survival (OS) was analyzed using time-to-event methods. Restricted cubic splines assessed non-linear associations between diagnosis year and hazards of death; multivariable Cox regression adjusted for age, sex, primary site, and metastatic status.
Results:
Among 9,420 patients, 5-year OS was 75.8% overall, 88.8% for non-metastatic disease, and 57.0% for metastatic disease. Mortality risk declined in more recent years, with diagnoses in 2013-2019 associated with lower hazards of death (adjusted HR 0.91, 95%CI 0.83-0.99). Improvements were confined to non-metastatic disease and to pancreas, stomach, and rectal primaries.
Conclusion:
OS has modestly improved over two decades, largely reflecting stage migration rather than clear therapeutic gains. Advances that meaningfully improve survival in advanced GEP-NENs are needed.
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