Research Paper Volume 16, Issue 5 pp 4204—4223
The crucial role of age and site in incidence and prognosis of female neuroendocrine neoplasms in the United States: a population-based study from 2000 to 2018
- 1 Department of Medical Oncology, Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- 2 Lung Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- 3 Laboratory of Integrative Medicine, Clinical Research Center for Breast, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University and Collaborative Innovation Center, Chengdu, Sichuan, China
- 4 Abdominal Oncology Ward, Division of Medical Oncology, Cancer Center, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan, China
Received: July 11, 2023 Accepted: November 17, 2023 Published: March 1, 2024
https://doi.org/10.18632/aging.205573How to Cite
Copyright: © 2024 Xiao et al. This is an open access article distributed under the terms of the Creative Commons Attribution License (CC BY 4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Abstract
Background: As the incidence continues to rise, global concern about neuroendocrine neoplasms (NENs) is mounting. However, little is known about how NENs affect women patients.
Methods: The annual percentage change (APC) was calculated to describe the incidence. Cox proportional hazards multivariable regression was used to identify risk factors. The nomograms were employed to estimate prognosis.
Results: A total of 39,237 female NENs (fNENs) cases were identified. The incidence of fNENs increased annually (APC = 4.5, 95% CI 4.1-4.8, P < 0.05), and the incidence pattern and survival outcomes showed age and site-specificity. Appendiceal, rectal, and pulmonary fNENs were major contributors to the incidence of patients younger than 40, between 40-59, and over 60 years old, respectively. The Cox proportional hazards regression model revealed that age, tumor size, grade, stage, and primary sites were closely related to survival. The worst survival outcomes appeared in breast, reproductive system, and liver fNENs for patients under 40, between 40-49, and over 50 years old, respectively. A nomogram based on these developed with higher predictive accuracy of prognosis, with a C index of 0.906 in the training cohort and 0.901 in the validation cohort.
Conclusions: Our findings revealed distinct site-specific tendencies in the incidence and survival patterns among fNEN patients across various age groups. Thus, reasonable patient screening and stratification strategies should be implemented, especially for young patients.
Abbreviations
NENs: neuroendocrine neoplasms; fNENs: female neuroendocrine neoplasms; OS: overall survival; APC: annual percentage change; SEER: Surveillance, Epidemiology, and End Results; NHW: Hispanic, non-Hispanic white; NHB: non-Hispanic black; NHAPI: non-Hispanic Asian or Pacific Islander; NHAIAN: non-Hispanic American Indian/Alaska Native; HRs: hazard ratios (HRs); CI: confidence interval.