Incidence and Survival Outcomes in Patients with Lung Neuroendocrine Neoplasms in the United States

Shrunjal Shah; Rohit Gosain; Adrienne Groman; Rahul Gosain; Arvind Dasari; Thorvardur R Halfdanarson; Sarbajit Mukherjee

doi:10.3390/cancers13081753

Incidence and Survival Outcomes in Patients with Lung Neuroendocrine Neoplasms in the United States

Cancers (Basel). 2021 Apr 7;13(8):1753. doi: 10.3390/cancers13081753.

Authors

Shrunjal Shah¹, Rohit Gosain², Adrienne Groman³, Rahul Gosain⁴, Arvind Dasari⁵, Thorvardur R Halfdanarson⁶, Sarbajit Mukherjee¹

Affiliations

¹ Department of Medicine/Hematology & Medical Oncology, Roswell Park Comprehensive Cancer Center, Buffalo, NY 14263, USA.
² Department of Medical Oncology and Hematology, UPMC Hillman Cancer Center, UPMC Chautauqua, 207 Foote Avenue, Jamestown, NY 14701, USA.
³ Department of Biostatistics and Bioinformatics, Roswell Park Comprehensive Cancer Center, Buffalo, NY 14263, USA.
⁴ Department of Medical Oncology and Hematology, Guthrie Corning Cancer Center, Corning, NY 14830, USA.
⁵ Department of GI Medical Oncology, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA.
⁶ Department of Oncology, Division of Medical Oncology, Mayo Clinic College of Medicine, Rochester, MN 55902, USA.

Abstract

Background: The incidence and prevalence of neuroendocrine neoplasms (NENs) are rapidly rising. Epidemiologic trends have been reported for common NENs, but specific data for lung NENs are lacking.

Methods: We conducted a retrospective analysis utilizing the Surveillance, Epidemiology, and End Results (SEER) database. Associated population data were utilized to report the annual age-adjusted incidence and overall survival (OS) trends. Trends for large-cell neuroendocrine carcinoma (LCNEC) and atypical carcinoid (AC) were reported from 2000-2015, while those for typical carcinoid (TC) and small cell lung cancer (SCLC) were reported from 1988-2015.

Results: We examined a total of 124,969 lung NENs [103,890-SCLC; 3303-LCNEC; 8146-TC; 656-AC; 8974-Other]. The age-adjusted incidence rate revealed a decline in SCLC from 8.6 in 1988 to 5.3 in 2015 per 100,000; while other NENs showed an increase: TC increased from 0.57 in 1988 to 0.77 in 2015, AC increased from 0.17 in 2001 to 0.22 in 2015, and LCNEC increased from 0.16 in 2000 to 0.41 in 2015. The 5-year OS rate among SCLC, LCNEC, AC, and TC patients was 5%, 17%, 64%, and 84%, respectively. On multivariable analyses, OS and disease-specific survival (DSS) varied significantly by stage, sex, histological type, insurance type, marital status, and race, with a better survival noted in earlier stages, females, married, insured, Hispanic and other races, and urban population. Similarly, TC and AC had better survival compared to SCLC and LCNEC.

Conclusion: The incidence of lung NENs is rising, possibly in part because of advanced radiological techniques. However, the incidence of SCLCs is waning, likely because of declining smoking habits. Such population-based studies are essential for resource allocation and to prioritize future research directions.

Keywords: SEER1; atypical carcinoid; bronchial neuroendocrine tumors; epidemiology; incidence; large cell lung carcinoma; neuroendocrine neoplasm; neuroendocrine tumors; prognosis; pulmonary neuroendocrine tumors; small cell lung cancer; survival; typical carcinoid.

Grants and funding

P30CA016056/CA/NCI NIH HHS/United States