Incidence and prognosis of patients with small intestinal neuroendocrine tumors in a population based nationwide study |
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| Institution: | 1. Faculty of Medicine, University of Iceland, Reykjavik, Iceland;2. Department of Pathology, Landspitali University Hospital of Iceland, Reykjavik, Iceland;3. Division of Gastroenterology and Hepatology, Department of Internal Medicine, Landspitali University Hospital of Iceland, Reykjavik, Iceland;1. Cancer Control Office, King Hussein Cancer Center, Amman 11941, Jordan;2. Section of Pulmonary and Critical Care, Department of Internal Medicine, King Hussein Cancer Center, Amman 11941, Jordan;3. Pharmacy Student, University of Jordan, Amman 11972, Jordan;4. Volunteer Research Program at King Hussein Cancer Center, Amman 11941, Jordan;5. Medical Student, University of Jordan, Amman 11972, Jordan;1. ICES, Toronto, Canada;2. Manitoba Centre for Health Policy, Department of Community Health Sciences, University of Manitoba, Winnipeg, Canada;3. Faculty of Health, Dalhousie University, Halifax, Canada;4. Dalla Lana School of Public Health, University of Toronto, Toronto, Canada;5. School of Rehabilitation Therapy, Queen’s University, Kingston, Canada;6. Institute for Health Policy, Management, and Evaluation, University of Toronto, Toronto, Canada;1. Maccabi Institute for Research and Innovation (Maccabitech), Maccabi Healthcare Services, HaMered 27, Tel Aviv, 68125, Israel;2. MSD Israel, Merck Sharp & Dohme (Israel-1996) Company Ltd. 34 Hacharash St. P.O.B 7340, Hod Hasharon 45240, Israel;3. Institute of Oncology, Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel;4. Department of Health Systems Management, Ben-Gurion University of the Negev, Beer-Sheva, Israel;5. Sackler Faculty of Medicine, Tel Aviv University, Israel;1. School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, VIC 3004, Australia;2. Victorian Melanoma Service, Alfred Health, 55 Commercial Road, Melbourne, VIC 3004, Australia;3. Department of Anatomical Pathology, Alfred Health, 55 Commercial Road, Melbourne, VIC 3004, Australia;4. Gastrointestinal and Other Cancers Research Group, Division of Cancer Prevention, National Cancer Institute, NIH, Bethesda, MD, USA;5. Walter Reed National Military Medical Center (WRNMM) Uniformed Services University (USU) Department of Surgery, Bethesda, MD, USA;6. The Walter & Eliza Hall Institute of Medical Research, University of Melbourne,1 G Royal Parade, Parkville, Victoria 3052, Australia;7. Clinical and Translational Epidemiology Unit, Massachusetts General Hospital, Massachusetts, USA;8. Department of Medical Oncology, Alfred Health, 55 Commercial Road, Melbourne, VIC 3004, Australia |
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| Abstract: | Background & aimsSmall intestinal neuroendocrine tumours (SI-NETs) are the most frequent malignant tumours of the small intestine. Population based studies on SI-NETs are scarce. We aimed to examine the incidence, presentation of disease and prognosis of SI-NET and to determine patient prognosis in those undergoing emergency or elective surgery.MethodsThis was a retrospective population-based study. Information on all patients diagnosed with neuroendocrine tumours of the small intestine (excluding duodenum) from the beginning of the Icelandic Cancer Registry and the pathology departments in the country (1966–2017). Detailed phenotypic information was obtained from medical records on symptoms at diagnosis, treatment, recurrence and survival.ResultsA total of 113 patients with SI-NETs were identified, 3 patients were excluded due to lack of data and/or diagnostic error, leaving 110 patients for final analysis. The incidence of SI-NET was 0.78/100,000 and did not increase during the study period. A total of 42 % (n = 46) of patients were diagnosed incidentally. Long-term prognosis, after a landmark of 12 months, was better in patients who were diagnosed incidentally (HR 0.52; p = 0.03). Overall 89 % (n = 98) of cases underwent surgical resection of the primary tumor, 31 % (n = 30) patients acute or semi-acute surgery and 69 % (n = 68) elective surgery. Emergency surgery was associated with a 6-fold risk of death in the first 12 months after surgery (HR: 5.99; p = 0.01) and associated with more severe surgical complications. However, there was no difference in the long-term risk of death after the first 12 months (HR: 1.39; p = 0.27).ConclusionsThe incidence of SI-NETs has not changed significantly in the last decades. Incidentally diagnosed SI-NET was associated with a favorable long-term prognosis. Emergency surgery in patients with SI-NET was associated with a significantly worse short-term risk of mortality compared to those who underwent elective surgery. |
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| Keywords: | Small intestinal neuroendocrine tumors Carcinoid Surgery Epidemiology |
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