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Article

Racial/Ethnic Disparities and Survival Characteristics in Non-Pancreatic Gastrointestinal Tract Neuroendocrine Tumors

1
Department of Internal Medicine, UT Southwestern Medical Center, Dallas, TX 75390, USA
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Division of Hematology and Oncology, UT Southwestern Medical Center, Dallas, TX 75390, USA
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Department of Internal Medicine, Capital Health Regional Medical Center, Trenton, NJ 08638, USA
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Department of Radiation Oncology, UT Southwestern Medical Center, Dallas, TX 75390, USA
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Department of Population and Data Sciences, UT Southwestern Medical Center, Dallas, TX 75390, USA
*
Author to whom correspondence should be addressed.
Cancers 2020, 12(10), 2990; https://doi.org/10.3390/cancers12102990
Received: 13 September 2020 / Revised: 9 October 2020 / Accepted: 13 October 2020 / Published: 15 October 2020
(This article belongs to the Section Cancer Epidemiology and Prevention)
The impact of race and ethnicity on survival characteristics in non-pancreatic gastrointestinal tract neuroendocrine tumors is understudied. We evaluated the survival outcomes and racial/ethnic disparities in the gastrointestinal tract neuroendocrine tumors, including the esophagus, stomach, small intestine, colon, rectum, and appendix. Survival trends were determined among three groups: Hispanic, non-Hispanic White, and non-Hispanic Black. We analyzed a large national database and found that race/ethnicity is an independent prognostic factor in patients with gastrointestinal neuroendocrine tumors. Hispanic patients had better overall survival than non-Hispanic White patients, whereas non-Hispanic Black patients had favorable cause-specific survival compared to non-Hispanic White patients. This survival disparity can be attributed to differences in the site of origin, age, and stage at presentation between various race/ethnicity. Understanding these differences between race and ethnicity is needed to reduce disparities in cancer outcomes.
Background: We studied the effect of race and ethnicity on disease characteristics and survival in gastrointestinal neuroendocrine tumors. Methods: The Surveillance, Epidemiology, and End Results database was used to select patients with non-pancreatic gastrointestinal neuroendocrine tumors diagnosed between 2004 and 2015. Trends in survival were evaluated among three groups: Hispanic, non-Hispanic White, and non-Hispanic Black. Kaplan–Meier and Cox regression methods were performed to calculate overall survival and cause-specific survival after adjusting for patient and tumor characteristics. Results: A total of 26,399 patients were included in the study: 65.1% were non-Hispanic White, 19.9% were non-Hispanic Black, and 15% were Hispanic. Non-Hispanic White patients were more likely to be male (50.0%, p < 0.001), older than 60 years (48.0%, p < 0.001), and present with metastatic disease (17.7%, p < 0.001). Non-Hispanic White patients had small intestine neuroendocrine tumors, while Hispanic and non-Hispanic Black patients had rectum neuroendocrine tumors as the most common primary site. Hispanic patients had better overall survival, while non-Hispanic Black patients had better cause-specific survival versus non-Hispanic White patients. This finding was confirmed on multivariable analysis where Hispanic patients had improved overall survival compared to non-Hispanic White patients (Hazard ratio (HR): 0.89 (0.81–0.97)), whereas non-Hispanic Black patients had better cause-specific survival compared to non-Hispanic White patients (HR: 0.89 (0.80–0.98)). Conclusions: Race/ethnicity is an independent prognostic factor in patients with gastrointestinal neuroendocrine tumors. View Full-Text
Keywords: neuroendocrine tumors; gastrointestinal tract; survival analysis; database; race factors neuroendocrine tumors; gastrointestinal tract; survival analysis; database; race factors
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MDPI and ACS Style

Goksu, S.Y.; Ozer, M.; Beg, M.S.; Sanford, N.N.; Ahn, C.; Fangman, B.D.; Goksu, B.B.; Verma, U.; Sanjeevaiah, A.; Hsiehchen, D.; Jones, A.L.; Kainthla, R.; Kazmi, S.M. Racial/Ethnic Disparities and Survival Characteristics in Non-Pancreatic Gastrointestinal Tract Neuroendocrine Tumors. Cancers 2020, 12, 2990. https://doi.org/10.3390/cancers12102990

AMA Style

Goksu SY, Ozer M, Beg MS, Sanford NN, Ahn C, Fangman BD, Goksu BB, Verma U, Sanjeevaiah A, Hsiehchen D, Jones AL, Kainthla R, Kazmi SM. Racial/Ethnic Disparities and Survival Characteristics in Non-Pancreatic Gastrointestinal Tract Neuroendocrine Tumors. Cancers. 2020; 12(10):2990. https://doi.org/10.3390/cancers12102990

Chicago/Turabian Style

Goksu, Suleyman Y., Muhammet Ozer, Muhammad S. Beg, Nina N. Sanford, Chul Ahn, Benjamin D. Fangman, Busra B. Goksu, Udit Verma, Aravind Sanjeevaiah, David Hsiehchen, Amy L. Jones, Radhika Kainthla, and Syed M. Kazmi. 2020. "Racial/Ethnic Disparities and Survival Characteristics in Non-Pancreatic Gastrointestinal Tract Neuroendocrine Tumors" Cancers 12, no. 10: 2990. https://doi.org/10.3390/cancers12102990

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