Prognostic Factors and Survival in Gastroenteropancreatic Neuroendocrine Neoplasm: Real-World Evidence from a South American Single-Center Cohort.

Abstract

Background: Gastroenteropancreatic neuroendocrine neoplasm (GEP-NEN) is a rare tumor, but with increasing global prevalence. However, data on epidemiology and survival in Latin America are sparse.

Objective: To describe clinical characteristics and survival in GEP-NEN treated at the Instituto Nacional de Cancerología in Bogotá, Colombia.

Methods: This retrospective observational study included patients diagnosed with GEP-NEN between January 1, 2008 and January 1, 2020. Clinical and pathological data were extracted from medical records. Survival analysis was conducted using Kaplan-Meier estimators and Cox proportional hazards models.

Results: A total of 204 patients were included. Median age was 55 years (range: 19-83); 61.3% were women. Most tumors (95.6%) were well-differentiated gastroenteropancreatic neuroendocrine tumors (NETs), and 55.9% of patients presented with stage IV disease. The most common primary tumor sites were the pancreas (25.5%) and the small intestine (23.5%). Median interval from symptom onset to diagnosis was 12 months, with 25% of patients requiring ≥2 years for diagnosis. Median follow-up was 105 months (95% CI: 87.6-115.2). Median overall survival was not reached. Poorer survival was significantly associated with higher tumor grade (p < 0.001), age >65 years (p = 0.035), and metastatic disease at diagnosis (p < 0.001). In contrast, surgical treatment was significantly associated with better overall survival (p = 0.006).

Conclusions: This study provides real-world evidence on outcomes in GEP-NEN in Latin America. Tumor grade, age, surgical treatment and metastasis at diagnosis were identified as key prognostic factors, highlighting the importance of early diagnosis and timely intervention.