Gastric Neuroendocrine Tumor Treatment and Survival Outcome Depends on Facility Type

Am Surg. 2023 Nov;89(11):4334-4343. doi: 10.1177/00031348221109460. Epub 2022 Jun 19.

Abstract

Background: Gastric neuroendocrine tumors (gNETs) are rare cancers for which surgery may improve survival. We aim to determine if facility type affects treatment and survival outcomes.

Methods: The NCDB was queried for patients with gNET from 2004-2016 and stratified into Academic/Research Program (ARP), Community Cancer Program (CCP), Comprehensive Community Cancer Program (CCCP), or Integrated Network Cancer Program (INCP). Overall survival along with clinical and demographic features was compared.

Results: Median survival was improved in patients treated at an academic program: 137.3 months versus 88.0, 96.3, and 100.2 for CCP, CCCP, INCP, respectively (P < .0001). Patients treated at academic centers were more likely to have surgery (64.2% vs 59.1%, 57.5%, 51.4%, P < .0001). After propensity matching for age, race, grade, stage, insurance status, and comorbidity score, survival benefit from treatment at an academic center remained (P = .03), particularly for patients undergoing surgery (P < .0001) and chemotherapy (P = .04).

Conclusion: Patients with gNET treated at an academic hospital had improved median survival after propensity matching and may benefit from treatment at academic rather than community medical centers.

MeSH terms

  • Carbonyl Cyanide m-Chlorophenyl Hydrazone
  • Hospitals
  • Humans
  • Neuroendocrine Tumors* / surgery
  • Pancreatic Neoplasms*
  • Retrospective Studies
  • Treatment Outcome

Substances

  • Carbonyl Cyanide m-Chlorophenyl Hydrazone

Supplementary concepts

  • Gastro-enteropancreatic neuroendocrine tumor