Department of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Department of Otorhinolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Front Endocrinol (Lausanne). 2023 Aug 28;14:1241724. doi: 10.3389/fendo.2023.1241724. eCollection 2023.
The epidemiologic trends and survival related to early-onset gastroenteropancreatic neuroendocrine neoplasms (GEP-NENs) have not been well explored.
Trends in the incidence and incidence-based mortality of early-onset GEP-NENs between 1975 and 2018 were obtained from the Surveillance, Epidemiology, and End Results database, and were stratified by age, sex, race, tumor site, stage, and grade. Associated population data were used to determine overall survival (OS) and independent prognostic factors for patients with early-onset GEP-NENs.
A total of 17299 patients diagnosed with early-onset GEP-NENs were included in this study. Results revealed an increase in the incidence (5.95% per year, 95% confidence interval (CI), 5.75-6.14%) and incidence-based mortality (4.24% per year, 95% CI, 3.92-4.56%) for early-onset GEP-NENs from 1975 to 2018, with higher rates of increase than those of later-onset GEP-NENs (incidence: 4.45% per year, 95% CI, 4.38-4.53; incidence-based mortality: 4.13% per year, 95% CI, 3.89-4.37; respectively). Increases in incidence were observed across all age, races, tumor sites, grades, and stages, except for patients with unknown stage. Compared to those with later-onset GEP-NENs, a higher proportion of female gender (54.5% vs. 49.0%, 0.001), well-differentiated tumor (31.1% vs. 28.0%, 0.05), and localized disease (55.2% vs. 46.7%, 0.05) were observed in the cohort of patients with early-onset GEP-NENs. Moreover, early-onset GEP-NENs exhibited a superior overall survival in comparison to later-onset GEP-NENs, irrespective of tumor site, grade, or stage (0.0001). Multivariable survival analysis identified that race, marital status, stage, grade, chemotherapy, and primary site were significantly correlated with OS in individuals with early-onset GEP-NENs.
The incidence and incidence-based mortality rates of early-onset GEP-NENs have steadily increased over time, with higher rates of increase than those of later-onset GEP-NENs. The clinical characteristics and survival were different between early-onset and later-onset GEP-NENs groups. Race, marital status, stage, grade, chemotherapy, and primary site were independent prognostic factors for early-onset GEP-NENs. Further investigations are warranted to better understand the characteristics of this disease subgroup.
早期发病的胃肠胰神经内分泌肿瘤（GEP-NENs）的流行病学趋势和生存相关问题尚未得到充分探讨。
从监测、流行病学和最终结果数据库中获取了 1975 年至 2018 年间早发性 GEP-NENs 的发病率和发病率为基础的死亡率趋势，并按年龄、性别、种族、肿瘤部位、分期和分级进行分层。使用相关人群数据确定了早发性 GEP-NENs 患者的总生存率（OS）和独立预后因素。
本研究共纳入 17299 例早发性 GEP-NENs 患者。结果显示，早发性 GEP-NENs 的发病率（每年 5.95%，95%置信区间（CI）5.75-6.14%）和发病率为基础的死亡率（每年 4.24%，95%CI 3.92-4.56%）从 1975 年到 2018 年稳步上升，其增长率高于晚发性 GEP-NENs（发病率：每年 4.45%，95%CI 4.38-4.53；发病率为基础的死亡率：每年 4.13%，95%CI 3.89-4.37；分别）。在所有年龄、种族、肿瘤部位、分级和分期中，除了未知分期的患者外，发病率都有所增加。与晚发性 GEP-NENs 患者相比，早发性 GEP-NENs 患者中女性（54.5%比 49.0%，0.001）、分化良好的肿瘤（31.1%比 28.0%，0.05）和局限性疾病（55.2%比 46.7%，0.05）的比例更高。此外，无论肿瘤部位、分级或分期如何，早发性 GEP-NENs 的总生存率均优于晚发性 GEP-NENs（0.0001）。多变量生存分析显示，种族、婚姻状况、分期、分级、化疗和原发部位与早发性 GEP-NENs 患者的 OS 显著相关。
早发性 GEP-NENs 的发病率和发病率为基础的死亡率呈稳步上升趋势，其增长率高于晚发性 GEP-NENs。早发性和晚发性 GEP-NENs 组之间的临床特征和生存情况不同。种族、婚姻状况、分期、分级、化疗和原发部位是早发性 GEP-NENs 的独立预后因素。需要进一步研究以更好地了解该疾病亚组的特征。
