Prognostic Analysis of Gastroenteropancreatic Neuroendocrine Neoplasms in Patients of Different Ages

Objective: To assess clinicopathological features and treatment options of patients with gastroenteropancreatic neuroendocrine neoplasms (GEP-NENs) at different ages and explore associations between age and five-year survival rate after surgery. Methods: In this hospital-based, nationwide, multicenter clinical epidemiological study, we retrospectively collected medical and survival data after surgery from 2, 010 patients with GEP-NENs enrolled in the study hospitals from January 2001 to December 2010. The Cox proportional hazard model was used to estimate the hazard ratio (HR) and 95% confidence interval (95% CI) to determine the risk for death after surgery. Results: The patients were assigned into two groups based on their age at diagnosis: ≤50 years and >50 years. Analysis of the five-year survival data after surgery revealed that the risk for death was significantly higher in patients aged >50 years than in those aged ≤50 years (HR=2.83, 95% CI: 1.87-4.28). After adjusting for primary sites, TNM stage, tumor grade, depth of invasion, lymph node metastasis and distant metastasis status, chemoradiotherapy, target therapy, and biotherapy, all HRs were not statistically significant (All P>0.05). Subgroup multivariate analysis according to sex showed that patients aged >50 years had significantly increased risks for death among male patients. Conclusions: Differences were noted in clinicopathological characteristics and treatment options of patients with GEP-NENs in different age groups. The five-year survival rate of patients with GEP-NENs aged >50 years is low, but age at diagnosis is not an independent factor affecting prognosis, indicating that according to the current clinical practice guidelines for GEP-NENs, precise and personalized treatment should be selected for patients with different ages at diagnosis.