Clinical outcomes of gastroenteropancreatic neuroendocrine neoplasms in Taiwan: A multicenter registry study-TCOG T1214 study.

Abstract

Gastroenteropancreatic neuroendocrine neoplasms (GEP-NENs) account for more than 50% of all NENs. The survival of patients with GEP-NENs has improved based on early diagnosis and improved treatment strategies. The real-world data of GEP-NENs in Taiwan are limited. A multicenter registry study was conducted to obtain real-world data on GEP-NENs in Taiwan. Patients with pathologically diagnosed GEP-NENs were enrolled. Data were on the baseline characteristics, treatment strategies, and patient survival. Also evaluated was the expression status of six biomarkers, including SSTR2, SSTR5, PDX-1, CDX-2, mASH1, and NeuroD, in tumors. Overall survival (OS) was analyzed and plotted via the Kaplan-Meier method. Cox regression analysis was used to analyze the prognostic factors of OS. A total of 600 GEP-NEN patients were enrolled. Pancreatic NENs accounted for 43.0% of all patients. The 5-year and 10-year OS rates of all patients were 70.9% and 61.3%, respectively. In the multivariable Cox regression analysis, older age (hazard ratio [HR] = 1.02; 95% CI, 1.01-1.03), higher Eastern Cooperative Oncology Group performance status score, higher tumor grade (World Health Organization classification) and stage 4 disease (HR = 6.22; 95% CI, 3.60-10.76) were associated with poor OS. Positive SSTR2 expression (HR = 0.53; 95% CI, 0.31-0.91) was associated with better OS according to multivariate Cox regression analysis. This study provides real-world data on 600 GEP-NENs in Taiwan and identifies age, Eastern Cooperative Oncology Group performance status score, tumor grade, tumor stage, and SSTR2 expression as prognostic factors for the survival of GEP-NENs.