NANETS2025 18th Annual Multidisciplinary NET Medical Symposium NANETS 2025 Clinical – Surgery/Applied Pathology (16 abstracts)
Survival outcomes after surgery for entero-pancreatic neuroendocrine tumors: a population-based analysis
Léamarie Meloche-Dumas 1 , Calvin Law 1 , Simron Singh 1 , Wing C Chan 2 , Anna Gombay 3 , Anna Ding 3 , Jessica Armah 3 , Sten Myrehaug 1 & Julie Hallet 1
1University of Toronto, Toronto, Canada; 2ICES, Toronto, Ontario; 3Sunnybrook Research Institute, Toronto, Ontario
Background: Surgery plays a key role in the management of entero-pancreatic neuroendocrine tumors (EP-NETs). Understanding contemporary outcomes is essential for integration in decision-making and patient counseling. We examined long-term outcomes following resection for EP-NETs.
Methods: We conducted a population-based retrospective cohort study of patients with EP-NETs (2000-2023) undergoing resection in Ontario, Canada. The outcome of interest was overall survival (OS), as time from surgery to death from any cause, examined using Kaplan-Meier curves. Cox proportional hazard (OS) models examined factors associated with OS.
Results: Of 3,536 patients included, 57.4% presented with metastases, 2,429 had small bowel (SB) NET (66.5% metastases) and 1,107 had P-NETs (37.5% metastases). Median follow-up was 6 years (IQR 3-10), and 1,144 patients (32.4%) died during follow-up. 10-year OS was 65.8% (95%CI 64.0-67.7%) after surgery overall, 67.1% (95%CI 65.0-69.4%) for SB-NETs and 59.9% (95%CI 56.3-63.6%) for P-NETs, after adjustment for age, sex, comorbidity burden, and year of surgery. In those with metastases, 10-year adjusted OS was 62.5% (95%CI 60.0-65.1%) for SB-NETs and 43.1% (95%CI 38.0-48.9%) for P-NETs. Advancing age, metastatic disease, and higher comorbidity burden were independently associated with inferior OS overall and for SB-NET and P-NETs, while female sex was independently associated with superior OS. Of all deaths, 642 were cancer-related. In the sub-group with metastases undergoing resection combined with hepatectomy, 10-year OS was 70% (95%CI 68-72) for SB-NETs and 10-year OS was 75% (95%CI 73-77) for P-NETs.
Conclusions: This study established contemporary long-term outcomes after resection of EP-NETs at the population-level. Patients with EP-NETs selected for surgery experience prolonged OS, driven by age, sex, and comorbidity burden, in addition to tumor factors. This information can be used to inform decision-making, patient counseling, and future trial designs.
Abstract ID #32975
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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