Measuring the improvement in overall survival among patients with advanced gastroenteropancreatic neuroendocrine tumors over the past two decades

To assess the changes in survival among patients with advanced well-differentiated gastroenteropancreatic neuroendocrine tumors (GEP-NETs) over the past two decades.
The Surveillance, Epidemiology and End Results database (SEER) was accessed, and cases with well-differentiated GEP-NETs that are labeled as having distant disease were included. We compared overall survival (OS) between patients diagnosed (2004–2013) vs. those diagnosed (2014–2022) using Kaplan–Meier survival estimates. We used multivariable Cox regression and competing risk analyses to evaluate factors associated with OS and cancer-specific survival (CSS).
Patients diagnosed earlier (2004–2013) were more likely to be white (p < 0.001), non-Hispanic (p < 0.001) and have a primary tumor location in the gastrointestinal tract (GIT) (p < 0.001) compared to those diagnosed later (2014–2022). For the overall cohort, unadjusted Kaplan–Meier survival estimates did not reveal a difference in OS between the two groups (median OS, 67 vs. 70 months; p = 0.385). When stratified based on primary tumor location, there was a difference among patients with GIT primary (p = 0.004) but not for those with pancreatic primary (p = 0.257).
On the other hand, multivariable Cox regression analysis showed worse OS (HR: 1.149 (95% CI: 1.070–1.234)) and CSS (HR: 1.180 (95% CI: 1.087–1.280) for patients diagnosed at an earlier period (2004–2013).
Based on multivariable analysis, patients with advanced well-differentiated GEP-NETs diagnosed at a later period (2014–2022) had better survival outcomes compared to those diagnosed at an earlier period (2004–2013).