Clinical Characteristics and Prognosis of Adolescents and Young Adults with Pancreatic Neuroendocrine Tumors: A Population-Based Study

Abstract

Background Pancreatic neuroendocrine tumors (PNETs) have recently shown an increasing incidence among younger individuals, yet population-based studies examining the clinical characteristics and prognosis specifically in adolescents and young adults (AYA) remain scarce. Methods All patients diagnosed with PNETs from 2000 to 2020 were identified through the Surveillance, Epidemiology, and End Results (SEER) database. Propensity score matching (PSM) was adopted to reduce selection bias. Kaplan-Meier analyses and Cox proportional hazards models were used to evaluate the impact of demographic and clinical variables on overall survival (OS) and cancer-specific survival (CSS). Results A total of 11728 patients were included in the study, with 887 in the AYA group and 10841 in the older adult (OA) group. Compared to the OA group, the AYA group had fewer Caucasians, more females, earlier clinical staging, lower distant metastasis rates, and higher surgical treatment rates (P < 0.05). The AYA group exhibited better OS (hazard ratio [HR] 0.50, 95% confidence interval [CI] 0.44–0.57, P < 0.001) and CSS (HR 0.58, 95% CI 0.51–0.67, P < 0.001). The mean 1-, 3-, and 5-year OS rates for AYA were 92.6%, 78.3%, and 66.4%, respectively, with corresponding CSS rates of 93.5%, 79.9%, and 68.4%. After PSM, the AYA group still exhibited better OS and CSS (P < 0.05). Multivariate Cox regression analysis identified sex, N stage, tumor size, surgery, and chemotherapy as independent risk factors for OS in AYA group, while sex, N stage, surgery, and chemotherapy were identified as risk factors for CSS. Conclusions This population-based study revealed that AYAs with PNETs exhibit a favorable prognosis and distinctive clinical features, while surgery and chemotherapy have the potential to enhance the prognosis for these individuals.