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Survival in patients with neuroendocrine tumors of the colon, rectum and small intestine

Published:October 01, 2022DOI:https://doi.org/10.1016/j.amjsurg.2022.09.053

      Highlights

      • Associated increase in survival of rectal well-differentiated neuroendocrine tumors, compared to colon and small intestine.
      • Rectal neuroendocrine tumor site of origin associated with improved 5-year overall survival.
      • Reduced 5-year overall survival with age > 80, males, distant disease, and poorly-differentiated neuroendocrine carcinomas.
      • Associated reduction in survival of rectal poorly-differentiated neuroendocrine carcinomas after resection.

      Abstract

      Background

      Neuroendocrine neoplasms (NENs) of the colon, rectum and small intestine (SI) are increasing in incidence and prevalence. We evaluated the 5-year overall survival (OS), and cancer-specific survival (CSS).

      Methods

      The Surveillance, Epidemiology, and End Results (SEER) 18 registry from 2000 to 2017 was accessed to identify patients with colonic, rectal, and SI NENs.

      Results

      46,665 patients were diagnosed with NENs of the colon (n = 10,518, 22.5%), rectum (18,063, 38.7%), and SI (18,084, 38.8%). By tumor site alone, patients with well-differentiated neuroendocrine tumors (NETs) of the rectum had improved 5-year OS (HR 0.72, 95% CI 0.68–0.77, p < 0.001). However, patients with rectal poorly-differentiated neuroendocrine carcinomas (NECs) who underwent oncologic resection had lower 5-year OS (35.1%) compared to colon (41.9%), and SI (72.5%).

      Conclusions

      Surgical resection may improve 5-year OS for NECs of the SI and colon, except in the rectum where survival was reduced. More frequent surveillance and timely initiation of systemic therapy should be considered for rectal NECs.
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