Findings of a population-based retrospective cohort study indicate that the risk for cancer-specific death exceeds the risk for noncancer death; however, patients with nonmetastatic neuroendocrine tumors (NETs) may have a higher risk for noncancer deaths.
A population-based retrospective cohort study was conducted to examine the contribution of cancer-specific and noncancer deaths after diagnosis of NETs to the overall survival of these patients; results of this analysis were reported at the 2020 American Society of Clinical Oncology Virtual Scientific Program.
This study included adult patients with NETs from 2001 to 2015 from linked administrative healthcare data sets. The cumulative incidence of cancer-specific and noncancer death was estimated using competing-risks methods; stratification was by primary tumor site of the NETs and metastatic status. Prognostic factors were assessed using subdistribution hazard models.
A total of 8607 patients were included in the cohort study. At a median follow-up of 42 months (interquartile range, 17-82), the 5-year risk for cancer-specific death was 27.3% (95% confidence interval [CI], 26.3%-28.4%), whereas the 5-year risk for noncancer death was much lower, at 5.6% (95% CI, 5.1%-6.1%). The higher risk for cancer-specific deaths relative to noncancer deaths particularly occurred in synchronous and metachronous metastatic NETs.
Differences were observed in risks for cancer-specific and non–cancer-specific deaths by primary tumor site. The highest risk for cancer-specific death was in bronchopulmonary and pancreatic NETs; however, the risk for noncancer deaths exceeded that of cancer-specific deaths for nonmetastatic gastric, small intestine, colonic, and rectal NETs. Prognostic factors such as advancing age, higher material deprivation, and metastases were found to be independently associated with a higher risk for cancer-specific death, whereas female sex and high comorbidity burden were associated with a lower risk for non–cancer-specific death.
The results of this large population-based study indicate that, in general, the risk for death resulting from cancer exceeds the risk for death from noncancer causes; however, the risk for cancer-specific death differs by primary tumor location, with a higher risk for noncancer deaths seen in patients with nonmetastatic NETs. This information is important for counselling, decision-making, and the design of future trials.
Source: Hallet J, et al. J Clin Oncol. 2020;38(15_suppl). Abstract 4605.
