Clinical Characteristics and Survival Associations of Pancreatic Neuroendocrine Tumor: Does Age Matter?

Abstract

Background: Pancreatic neuroendocrine tumor (pNET) is the second most common epithelial neoplasm of pancreas. As in pancreatic adenocarcinoma, patients with different onset ages display different clinical features and prognosis, we divided pNET patients into early-onset pancreatic neuroendocrine tumor (EOpNET) and typical age-at-onset pancreatic neuroendocrine tumor (TOpNET) to investigate the effect of onset age on its clinical characteristics and prognosis. Methods: Data were collected from the Surveillance, Epidemiology, and End Results (SEER) database (2004–2015; cohort 1) and Fudan University Shanghai Cancer Center (FUSCC) (2005–2018; cohort 2) retrospectively. The clinical characteristics were compared using chi-squared tests. Cox proportional hazards regression was used to evaluate hazard ratios (HRs) and 95% confidence intervals (CIs), and overall survival were formulated by Kaplan–Meier curves.Results: In total 5,368 and 330 patients’ data were included from the SEER database and FUSCC. Gender had no effect on survival in EOpNET group. Tumors locating in the tail (HR: 0.721, 95%CI: 0.63-0.83, P < 0.001) and body (HR: 0.712, 95%CI: 0.60-0.85, P = 0.001) had lower risks of death compared to tumors in the head in TOpNET group. The overall survival of EOpNET (136 (3-143) months) was better than TOpNET (85 (3-143) months) ( P < 0.001) in SEER database. The results in FUSCC was similar with SEER cohort. Conclusions: EOpNET group had significantly better overall survival than TOpNET though their clinical characteristics were not significantly different. In the future personalized treatment of pNET, the onset age of patients will become another important factor for guiding the treatment and prognosis.