Sex Differences in Survival from Neuroendocrine Neoplasia in England 2012–2018: A Retrospective, Population-Based Study
Pre-clinical studies have suggested sex hormone signalling pathways may influence tumorigenesis in neuroendocrine neoplasia (NEN). We conducted a retrospective, population-based study to compare overall survival (OS) between males and females with NEN. A total of 14,834 cases of NEN diagnosed betwee...
| Main Authors: | , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2023-03-01
|
| Series: | Cancers |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2072-6694/15/6/1863 |
| _version_ | 1797612924924067840 |
|---|---|
| author | Benjamin E. White Beth Russell Sebastiaan Remmers Brian Rous Kandiah Chandrakumaran Kwok F. Wong Mieke Van Hemelrijck Rajaventhan Srirajaskanthan John K. Ramage |
| author_facet | Benjamin E. White Beth Russell Sebastiaan Remmers Brian Rous Kandiah Chandrakumaran Kwok F. Wong Mieke Van Hemelrijck Rajaventhan Srirajaskanthan John K. Ramage |
| author_sort | Benjamin E. White |
| collection | DOAJ |
| description | Pre-clinical studies have suggested sex hormone signalling pathways may influence tumorigenesis in neuroendocrine neoplasia (NEN). We conducted a retrospective, population-based study to compare overall survival (OS) between males and females with NEN. A total of 14,834 cases of NEN diagnosed between 2012 and 2018, recorded in England’s National Cancer Registry and Analysis Service (NCRAS), were analysed. The primary outcome was OS with 5 years maximum follow-up. Multivariable analysis, restricted mean survival time and mediation analysis were performed. Appendiceal, pulmonary and early-stage NEN were most commonly diagnosed in females; stomach, pancreatic, small intestinal, colonic, rectal and later-stage NEN were more often diagnosed in males. Females displayed increased survival irrespective of the stage, morphology or level of deprivation. On average, they survived 3.62 (95% CI 1.73–5.90) to 10.26 (6.6–14.45) months longer than males; this was statistically significant in NEN of the lung, pancreas, rectum and stomach (<i>p</i> < 0.001). The stage mediated improved survival in stomach, lung, and pancreatic NEN but not in rectal NEN. The reasons underlying these differences are not yet understood. Overall, females diagnosed with NEN tend to survive longer than males, and the stage at presentation only partially explains this. Future research, as well as prognostication and treatment, should consider sex as an important factor. |
| first_indexed | 2024-03-11T06:48:44Z |
| format | Article |
| id | doaj.art-8af31fbfe83749dabc5ee596a8d0bcad |
| institution | Directory Open Access Journal |
| issn | 2072-6694 |
| language | English |
| last_indexed | 2024-03-11T06:48:44Z |
| publishDate | 2023-03-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Cancers |
| spelling | doaj.art-8af31fbfe83749dabc5ee596a8d0bcad2023-11-17T10:08:15ZengMDPI AGCancers2072-66942023-03-01156186310.3390/cancers15061863Sex Differences in Survival from Neuroendocrine Neoplasia in England 2012–2018: A Retrospective, Population-Based StudyBenjamin E. White0Beth Russell1Sebastiaan Remmers2Brian Rous3Kandiah Chandrakumaran4Kwok F. Wong5Mieke Van Hemelrijck6Rajaventhan Srirajaskanthan7John K. Ramage8Basingstoke and North Hampshire Hospital, Hampshire Hospitals NHS Foundation Trust, Basingstoke RG24 9NA, UKTranslational Oncology and Urology Research, School of Cancer & Pharmaceutical Sciences, King’s College London, London WC2R 2LS, UKDepartment of Urology, Erasmus MC Cancer Institute, University Medical Center Rotterdam, 3015 GD Rotterdam, The NetherlandsNHS Digital, 7 and 8 Wellington Place, Leeds LS1 4AP, UKBasingstoke and North Hampshire Hospital, Hampshire Hospitals NHS Foundation Trust, Basingstoke RG24 9NA, UKNHS Digital, 7 and 8 Wellington Place, Leeds LS1 4AP, UKTranslational Oncology and Urology Research, School of Cancer & Pharmaceutical Sciences, King’s College London, London WC2R 2LS, UKKing’s Health Partners ENETS Centre of Excellence, King’s College Hospital, London SE5 9RS, UKBasingstoke and North Hampshire Hospital, Hampshire Hospitals NHS Foundation Trust, Basingstoke RG24 9NA, UKPre-clinical studies have suggested sex hormone signalling pathways may influence tumorigenesis in neuroendocrine neoplasia (NEN). We conducted a retrospective, population-based study to compare overall survival (OS) between males and females with NEN. A total of 14,834 cases of NEN diagnosed between 2012 and 2018, recorded in England’s National Cancer Registry and Analysis Service (NCRAS), were analysed. The primary outcome was OS with 5 years maximum follow-up. Multivariable analysis, restricted mean survival time and mediation analysis were performed. Appendiceal, pulmonary and early-stage NEN were most commonly diagnosed in females; stomach, pancreatic, small intestinal, colonic, rectal and later-stage NEN were more often diagnosed in males. Females displayed increased survival irrespective of the stage, morphology or level of deprivation. On average, they survived 3.62 (95% CI 1.73–5.90) to 10.26 (6.6–14.45) months longer than males; this was statistically significant in NEN of the lung, pancreas, rectum and stomach (<i>p</i> < 0.001). The stage mediated improved survival in stomach, lung, and pancreatic NEN but not in rectal NEN. The reasons underlying these differences are not yet understood. Overall, females diagnosed with NEN tend to survive longer than males, and the stage at presentation only partially explains this. Future research, as well as prognostication and treatment, should consider sex as an important factor.https://www.mdpi.com/2072-6694/15/6/1863neuroendocrine tumourneuroendocrine tumourneuroendocrine neoplasiacarcinoidepidemiologysurvival |
| spellingShingle | Benjamin E. White Beth Russell Sebastiaan Remmers Brian Rous Kandiah Chandrakumaran Kwok F. Wong Mieke Van Hemelrijck Rajaventhan Srirajaskanthan John K. Ramage Sex Differences in Survival from Neuroendocrine Neoplasia in England 2012–2018: A Retrospective, Population-Based Study Cancers neuroendocrine tumour neuroendocrine tumour neuroendocrine neoplasia carcinoid epidemiology survival |
| title | Sex Differences in Survival from Neuroendocrine Neoplasia in England 2012–2018: A Retrospective, Population-Based Study |
| title_full | Sex Differences in Survival from Neuroendocrine Neoplasia in England 2012–2018: A Retrospective, Population-Based Study |
| title_fullStr | Sex Differences in Survival from Neuroendocrine Neoplasia in England 2012–2018: A Retrospective, Population-Based Study |
| title_full_unstemmed | Sex Differences in Survival from Neuroendocrine Neoplasia in England 2012–2018: A Retrospective, Population-Based Study |
| title_short | Sex Differences in Survival from Neuroendocrine Neoplasia in England 2012–2018: A Retrospective, Population-Based Study |
| title_sort | sex differences in survival from neuroendocrine neoplasia in england 2012 2018 a retrospective population based study |
| topic | neuroendocrine tumour neuroendocrine tumour neuroendocrine neoplasia carcinoid epidemiology survival |
| url | https://www.mdpi.com/2072-6694/15/6/1863 |
| work_keys_str_mv | AT benjaminewhite sexdifferencesinsurvivalfromneuroendocrineneoplasiainengland20122018aretrospectivepopulationbasedstudy AT bethrussell sexdifferencesinsurvivalfromneuroendocrineneoplasiainengland20122018aretrospectivepopulationbasedstudy AT sebastiaanremmers sexdifferencesinsurvivalfromneuroendocrineneoplasiainengland20122018aretrospectivepopulationbasedstudy AT brianrous sexdifferencesinsurvivalfromneuroendocrineneoplasiainengland20122018aretrospectivepopulationbasedstudy AT kandiahchandrakumaran sexdifferencesinsurvivalfromneuroendocrineneoplasiainengland20122018aretrospectivepopulationbasedstudy AT kwokfwong sexdifferencesinsurvivalfromneuroendocrineneoplasiainengland20122018aretrospectivepopulationbasedstudy AT miekevanhemelrijck sexdifferencesinsurvivalfromneuroendocrineneoplasiainengland20122018aretrospectivepopulationbasedstudy AT rajaventhansrirajaskanthan sexdifferencesinsurvivalfromneuroendocrineneoplasiainengland20122018aretrospectivepopulationbasedstudy AT johnkramage sexdifferencesinsurvivalfromneuroendocrineneoplasiainengland20122018aretrospectivepopulationbasedstudy |