Gastroenteropancreatic neuroendocrine neoplasms: A 20-year experience at a tertiary care medical center in Mexico City

INTRODUCTION AND AIMS: Neuroendocrine neoplasms are a heterogeneous group of tumors, primarily located in the gastroenteropancreatic system. In Mexico, clinical and epidemiologic data on them are limited. Our aim was to describe the experience with gastroenteropancreatic neuroendocrine neoplasms at a tertiary care medical center and analyze the factors associated with survival. MATERIALS AND METHODS: A retrospective analytic cohort study was conducted. RESULTS: The study included 110 patients with a mean age of 58 years (SD ± 13.8), 55.5% of whom were women. The pancreas was the most common primary site (50%). Functional tumors accounted for 28.2% of cases and carcinoid syndrome for 9.1%. Performance status was preserved in 96.3% of patients (ECOG 0-1). At diagnosis, 50% presented with advanced disease, of whom 61.3% had high hepatic tumor burden. The median follow-up period was 37.5 months. Overall survival (OS) was 162 months (SD ± 12.8). The factors associated with better OS were preserved performance status (p < 0.001), CgA ≤ 700 ng/mL (p = 0.02), Ki-67 < 5% (p = 0.03), and low hepatic tumor burden (p = 0.02). The factors associated with better progression-free survival were preserved performance status (p = 0.022), histologic grade (p = 0.02), CgA ≤ 700 ng/mL (p = 0.03), and objective response rate (p < 0.001). CONCLUSIONS: At our medical center, the most frequent primary site was the pancreas and most of the patients were women, differing from international reports. Factors associated with better survival were identified, including preserved performance status, CgA ≤ 700 ng/mL, histologic grade, Ki-67 < 5%, low hepatic tumor burden, and objective response rate.