Faculty of Medicine, University of Iceland, Reykjavik, Iceland.
Faculty of Medicine, University of Iceland, Reykjavik, Iceland; Department of Pathology, Landspitali University Hospital of Iceland, Reykjavik, Iceland.
Cancer Epidemiol. 2022 Aug;79:102197. doi: 10.1016/j.canep.2022.102197. Epub 2022 Jun 16.
BACKGROUND & AIMS: Small 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.
This 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.
A 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).
The 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.
小肠类癌（SI-NETs）是小肠最常见的恶性肿瘤。基于人群的 SI-NET 研究很少。我们旨在研究 SI-NET 的发病率、疾病表现和预后，并确定接受急诊或择期手术的患者的预后。
这是一项回顾性基于人群的研究。从冰岛癌症登记处和全国病理科（1966-2017 年）开始，获取所有诊断为小肠神经内分泌肿瘤（不包括十二指肠）的患者信息。详细的表型信息来自于病历中的诊断时症状、治疗、复发和生存情况。
共确定了 113 例 SI-NET 患者，由于数据缺失和/或诊断错误，有 3 例被排除，最终有 110 例患者进行了最终分析。SI-NET 的发病率为 0.78/100,000，在研究期间没有增加。42%（n=46）的患者为偶然诊断。在 12 个月的时间点后，偶然诊断的患者具有更好的长期预后（HR 0.52；p=0.03）。总体上，89%（n=98）的病例接受了原发性肿瘤的手术切除，31%（n=30）患者接受了急性或半急性手术，69%（n=68）患者接受了择期手术。急诊手术与术后 12 个月内死亡风险增加 6 倍相关（HR：5.99；p=0.01），并与更严重的手术并发症相关。然而，在术后 12 个月后，死亡风险无差异（HR：1.39；p=0.27）。
在过去几十年中，SI-NET 的发病率没有明显变化。偶然诊断的 SI-NET 与良好的长期预后相关。与择期手术相比，SI-NET 患者的急诊手术与短期死亡率显著增加相关。
