Incidence, Clinical Presentation and Trends in Indication for Diagnostic Work-Up of Small Intestinal and Pancreatic Neuroendocrine Tumors

Background: The incidence of small intestinal (SI) and pancreatic neuroendocrine tumors (siNETs and pNETs) seems to have increased. The increased frequency of incidental findings might be a possible explanation. The study aimed to examine (1) changes in incidence and the stage at diagnosis (2010–201...

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Autores principales:	Anna Bryan Stensbøl, Jesper Krogh, Pernille Holmager, Marianne Klose, Peter Oturai, Andreas Kjaer, Carsten Palnæs Hansen, Birgitte Federspiel, Seppo W. Langer, Ulrich Knigge, Mikkel Andreassen
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	small intestinal and pancreatic neuroendocrine tumors incidence clinical presentation incidentaloma Medicine (General) R5-920
Acceso en línea:	https://doaj.org/article/7d8e6c2923734c5088515b0cfd7b050e
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spelling	oai:doaj.org-article:7d8e6c2923734c5088515b0cfd7b050e2021-11-25T17:20:57ZIncidence, Clinical Presentation and Trends in Indication for Diagnostic Work-Up of Small Intestinal and Pancreatic Neuroendocrine Tumors10.3390/diagnostics111120302075-4418https://doaj.org/article/7d8e6c2923734c5088515b0cfd7b050e2021-11-01T00:00:00Zhttps://www.mdpi.com/2075-4418/11/11/2030https://doaj.org/toc/2075-4418Background: The incidence of small intestinal (SI) and pancreatic neuroendocrine tumors (siNETs and pNETs) seems to have increased. The increased frequency of incidental findings might be a possible explanation. The study aimed to examine (1) changes in incidence and the stage at diagnosis (2010–2011 vs. 2019–2020), (2) changes in the initial indication for diagnostic workup and 3) the differences in stage between incidentally discovered vs. symptomatic disease during the entire study period. Methods: We performed a retrospective study, that includes consecutive siNET and pNET patients referred to the Copenhagen ENETS center of excellence in 2010–2011 and 2019–2020. Results: The annual incidence of siNET per 100,000 increased from 1.39 to 1.84, (<i>p</i> = 0.05). There was no change in the stage at diagnosis, and in both periods approximately 30% of patients were incidentally diagnosed (<i>p</i> = 0.62). Dissemination was found in 72/121 (60%) of symptomatic vs. 22/50 (44%) of incidentally discovered SI tumors in the entire cohort, (<i>p</i> = 0.06). The annual incidence of pNET increased from 0.42 to 1.39 per 100,000, (<i>p</i> < 0.001). The proportion of patients with disseminated disease decreased from 8/21 (38%) to 12/75 (16%), (<i>p</i> = 0.02) and the number of incidental findings increased from 4/21 (19%) to 43/75 (57%), (<i>p</i> = 0.002). More symptomatic patients had disseminated disease compared to patients with incidentally discovered tumors (15/49 (31%) vs. 5/47 (11%), (<i>p</i> = 0.01)). Conclusion: The incidence of siNET and pNETs increased over the past decade. For siNETs, the stage of disease and the distribution of symptomatic vs. incidentally discovered tumors were unchanged between the two periods. Patients with pNETs presented with more local and incidentally discovered tumors in the latter period. Patients with incidentally discovered siNETs had disseminated disease in 44% of the overall cases. The vast majority of incidentally found pNETs were localized.Anna Bryan StensbølJesper KroghPernille HolmagerMarianne KlosePeter OturaiAndreas KjaerCarsten Palnæs HansenBirgitte FederspielSeppo W. LangerUlrich KniggeMikkel AndreassenMDPI AGarticlesmall intestinal and pancreatic neuroendocrine tumorsincidenceclinical presentationincidentalomaMedicine (General)R5-920ENDiagnostics, Vol 11, Iss 2030, p 2030 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	small intestinal and pancreatic neuroendocrine tumors incidence clinical presentation incidentaloma Medicine (General) R5-920
spellingShingle	small intestinal and pancreatic neuroendocrine tumors incidence clinical presentation incidentaloma Medicine (General) R5-920 Anna Bryan Stensbøl Jesper Krogh Pernille Holmager Marianne Klose Peter Oturai Andreas Kjaer Carsten Palnæs Hansen Birgitte Federspiel Seppo W. Langer Ulrich Knigge Mikkel Andreassen Incidence, Clinical Presentation and Trends in Indication for Diagnostic Work-Up of Small Intestinal and Pancreatic Neuroendocrine Tumors
description	Background: The incidence of small intestinal (SI) and pancreatic neuroendocrine tumors (siNETs and pNETs) seems to have increased. The increased frequency of incidental findings might be a possible explanation. The study aimed to examine (1) changes in incidence and the stage at diagnosis (2010–2011 vs. 2019–2020), (2) changes in the initial indication for diagnostic workup and 3) the differences in stage between incidentally discovered vs. symptomatic disease during the entire study period. Methods: We performed a retrospective study, that includes consecutive siNET and pNET patients referred to the Copenhagen ENETS center of excellence in 2010–2011 and 2019–2020. Results: The annual incidence of siNET per 100,000 increased from 1.39 to 1.84, (<i>p</i> = 0.05). There was no change in the stage at diagnosis, and in both periods approximately 30% of patients were incidentally diagnosed (<i>p</i> = 0.62). Dissemination was found in 72/121 (60%) of symptomatic vs. 22/50 (44%) of incidentally discovered SI tumors in the entire cohort, (<i>p</i> = 0.06). The annual incidence of pNET increased from 0.42 to 1.39 per 100,000, (<i>p</i> < 0.001). The proportion of patients with disseminated disease decreased from 8/21 (38%) to 12/75 (16%), (<i>p</i> = 0.02) and the number of incidental findings increased from 4/21 (19%) to 43/75 (57%), (<i>p</i> = 0.002). More symptomatic patients had disseminated disease compared to patients with incidentally discovered tumors (15/49 (31%) vs. 5/47 (11%), (<i>p</i> = 0.01)). Conclusion: The incidence of siNET and pNETs increased over the past decade. For siNETs, the stage of disease and the distribution of symptomatic vs. incidentally discovered tumors were unchanged between the two periods. Patients with pNETs presented with more local and incidentally discovered tumors in the latter period. Patients with incidentally discovered siNETs had disseminated disease in 44% of the overall cases. The vast majority of incidentally found pNETs were localized.
format	article
author	Anna Bryan Stensbøl Jesper Krogh Pernille Holmager Marianne Klose Peter Oturai Andreas Kjaer Carsten Palnæs Hansen Birgitte Federspiel Seppo W. Langer Ulrich Knigge Mikkel Andreassen
author_facet	Anna Bryan Stensbøl Jesper Krogh Pernille Holmager Marianne Klose Peter Oturai Andreas Kjaer Carsten Palnæs Hansen Birgitte Federspiel Seppo W. Langer Ulrich Knigge Mikkel Andreassen
author_sort	Anna Bryan Stensbøl
title	Incidence, Clinical Presentation and Trends in Indication for Diagnostic Work-Up of Small Intestinal and Pancreatic Neuroendocrine Tumors
title_short	Incidence, Clinical Presentation and Trends in Indication for Diagnostic Work-Up of Small Intestinal and Pancreatic Neuroendocrine Tumors
title_full	Incidence, Clinical Presentation and Trends in Indication for Diagnostic Work-Up of Small Intestinal and Pancreatic Neuroendocrine Tumors
title_fullStr	Incidence, Clinical Presentation and Trends in Indication for Diagnostic Work-Up of Small Intestinal and Pancreatic Neuroendocrine Tumors
title_full_unstemmed	Incidence, Clinical Presentation and Trends in Indication for Diagnostic Work-Up of Small Intestinal and Pancreatic Neuroendocrine Tumors
title_sort	incidence, clinical presentation and trends in indication for diagnostic work-up of small intestinal and pancreatic neuroendocrine tumors
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/7d8e6c2923734c5088515b0cfd7b050e
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Incidence, Clinical Presentation and Trends in Indication for Diagnostic Work-Up of Small Intestinal and Pancreatic Neuroendocrine Tumors

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