Department of Oncology, Cross Cancer Institute and the University of Alberta, Edmonton, Alberta, Canada.
Am J Clin Oncol. 2022 Aug 1;45(8):338-343. doi: 10.1097/COC.0000000000000925. Epub 2022 Jun 7.
The objective of this study was to evaluate the incidence and outcomes of adults with early-onset (20 to 34 y) diagnosis of well-differentiated neuroendocrine neoplasms.
Surveillance, Epidemiology, and End Results (SEER)-18 database was accessed, and patients with well-differentiated lung or digestive tract neuroendocrine neoplasms diagnosed 2000 to 2018 were reviewed. Annual percent changes (APCs) were calculated for the 3 disease subsites (foregut, midgut, and hindgut) stratified by age group. Kaplan-Meier survival estimates/log-rank testing were used to examine differences in overall survival between the 3 age groups. Multivariable Cox regression analyses were used to evaluate factors affecting overall and cancer-specific survivals.
Throughout the study period, patients with early-onset disease (20 to 34 y) have experienced the greatest APC (20 to 34 y: 9.7; 35 to 49 y: 5.4; ≥50 y: 4.1). When APCs were stratified by disease subsite, this difference in APCs appears to be driven by midgut tumors (20 to 34 y: 19.2; 35 to 49: 8.4; ≥50 y: 3.8). Using multivariable Cox regression modeling, the following variables were associated with a higher risk of all-cause death (worse overall survival): male sex (hazard ratio [HR] 1.27; 95% confidence interval [CI]: 1.22-1.31), African American race (HR vs. white race: 1.20; 95% CI: 1.15-1.26), nonhindgut primary (HR foregut vs. hindgut primary: 2.02; 95% CI: 1.91-2.13; HR midgut vs. hindgut primary: 2.09; 95% CI: 1.95-2.24), distant disease (HR vs. regional disease: 2.06; 95% CI: 1.96-2.18), no surgery to the primary (HR: 2.34; 95% CI: 2.24-2.46), and older age (HR: 5.80; 95% CI: 4.87-6.91).
Cases of early-onset well-differentiated neuroendocrine neoplasms have disproportionately increased over the past 2 decades (compared with other age groups), and this appears to have been driven mainly by midgut tumors.
本研究旨在评估早发性（20 至 34 岁）分化良好的神经内分泌肿瘤成人患者的发病率和结局。
我们访问了监测、流行病学和最终结果（SEER）-18 数据库，并回顾了 2000 年至 2018 年期间诊断为分化良好的肺或消化道神经内分泌肿瘤的患者。按年龄组对 3 个疾病部位（前肠、中肠和后肠）进行分层，计算每年的百分比变化（APC）。Kaplan-Meier 生存估计/对数秩检验用于比较 3 个年龄组之间的总生存率差异。多变量 Cox 回归分析用于评估影响总生存率和癌症特异性生存率的因素。
在整个研究期间，早发性疾病（20 至 34 岁）患者的 APC 最大（20 至 34 岁：9.7%；35 至 49 岁：5.4%；≥50 岁：4.1%）。当 APC 按疾病部位分层时，这种 APC 差异似乎是由中肠肿瘤驱动的（20 至 34 岁：19.2%；35 至 49 岁：8.4%；≥50 岁：3.8%）。使用多变量 Cox 回归模型，以下变量与全因死亡风险增加（总生存率较差）相关：男性（危险比 [HR] 1.27；95%置信区间 [CI]：1.22-1.31）、非裔美国人（与白人相比 HR：1.20；95%CI：1.15-1.26）、非后肠原发肿瘤（与后肠原发肿瘤相比 HR 前肠 vs. 后肠：2.02；95%CI：1.91-2.13；HR 中肠 vs. 后肠原发肿瘤：2.09；95%CI：1.95-2.24）、远处疾病（与局部疾病相比 HR：2.06；95%CI：1.96-2.18）、原发肿瘤无手术（HR：2.34；95%CI：2.24-2.46）和年龄较大（HR：5.80；95%CI：4.87-6.91）。
在过去 20 年中，早发性分化良好的神经内分泌肿瘤病例不成比例地增加（与其他年龄组相比），这似乎主要是由中肠肿瘤驱动的。
