Epidemiologic trends and prognostic risk factors of patients with pancreatic neuroendocrine neoplasms in the US: an updated population-based study

Background: We aimed to evaluate the incidence, mortality and survival outcome for patients with pancreatic neuroendocrine neoplasms (pNEN). Methods: Patients with pNEN were collected from the Surveillance, Epidemiology, and End Results (SEER) database. Incidence, mortality and average annual percentage change (AAPC) were calculated using SEER stat 8.3.6 and Joinpoint software. Survival outcome was estimated using Kaplan-Meier and Cox proportional hazard model. Results: During 2000-2016, the incidence of pNEN significantly rose from 0.2647 to 1.0618 per 100,000 persons with an AAPC of 9.4; AAPC of mortality was 6.7. Prognostic improvement was revealed in 2010-2016, but not for late-stage pNEN, which had the highest risk of death. Conclusion: Efforts to improve prognosis of pNEN patients must focus on not only early detection, but also on improving therapy for late-stage disease. Lay abstract An increasing number of US patients have been identified in recent years (2000-2016) with cancer of the pancreas of the neuroendocrine type. Interestingly, this is especially true for early-stage cancer. This goes along with an increased awareness of patients and physicians for this type of cancer as well as improvements in medical imaging and screening. However, if this cancer is only detected late, the survival chances remain poor. Therefore, future clinical management and research should not only focus on further improving early detection, but also on the development of more effective therapies for late stages of pancreatic neuroendocrine cancer.