A. K. Idicula2, S. Dissanaike2, M. S. Wachtel1 2Texas Tech University Health Sciences Center,Surgery,Lubbock, TEXAS, USA 1Texas Tech University Health Sciences Center,Pathology,Lubbock, TX, USA
Introduction:
Neuroendocrine carcinoma is not uncommonly seen in the stomach and more distal gastrointestinal tract, but its relative incidence and mortality among the several primary sites has not been fully evaluated. Neither have secular trends been compared. We hypothesized that examining a large database would provide better understanding of these tumors as respects the different gastrointestinal sites.
Methods:
Patients were included if they had histologically proven neuroendocrine carcinoma (ICD-O-3 8002, 8013, 8041-8045, 8240-8246, 8249), if they were at least 20 years old, and if the primary site was the stomach (ICD-O-3 C16.1-C16.9), the small bowel (ICD-O-3 C17.1-C17.9), the appendix (ICD-O-3 C18.1), or the large intestine (ICD-O-3 C18.0, C18.2-C18.9, C19.9, C20.9). SEER*Stat 8.2.1 queried SEER 13 registries for 1988-2012 incidence and incidence based mortality rates and standard errors. Joinpoint 4.1.2 calculated estimates and standard errors of annual percent changes (APC) and joinpoints and performed tests of parallelism.
Results:
Evaluated were 17,197 cases of and 7,054 deaths. The figure shows incidence and mortality rates and APC by primary site. For all sites, mortality and incidence increased between 1988 and 2012. The least common source of tumors and tumor deaths was the stomach. The most common source of tumors was the large intestine. The most common source of tumor deaths was the small intestine. Parallelism tests showed for incidence, only the stomach and the large intestine (P = 0.53) bore similar APC; for mortality, only the stomach and the appendix (P = 0.83) and the stomach and the large intestine (P = 0.72) bore similar APC. Apart from a non-statistically significant decline in large intestinal incidence rates, APC -4.4 (95% CI -15.0, 7.5), rates were increasing at periods ending in 2012: for incidence, stomach APC 3.3 (95% CI 1.2, 5.4), small intestine APC 3.7 (95% CI 3.3, 4.1), appendix APC 7.2 (95% CI 5.7, 8.7); for incidence based mortality, stomach APC 4.2 (95% CI 2.8, 5.6), small intestine APC 2.1 (95% CI 1.3, 2.8), appendix APC 4.4 (95% CI 2.5, 6.2) , large intestine APC 11.3 (95% CI 1.8, 21.7).
Conclusion:
Neuroendocrine carcinoma of the stomach, the small intestine, the appendix, and the large intestine shows increasing incidence and mortality rates. Rates and rate changes in general differed among sites. Results support the notion of gastrointestinal diversity as respects neuroendocrine carcinoma.
