Abstract A070: Real world treatment patterns and patient outcomes of neuroendocrine tumors: A single institution study
Authors: Gutta Radhika , Wan-Ting su  , She Ruicond , Shahid Muhammad , Khan Gazala 
Published: September 2024

Neuroendocrine tumors (NETs) are rare and diverse, with increasing incidence but poorly understood prognostic variables. While African American or Black patients typically have poorer outcomes across various tumor types, this is not well documented for NETs. Our study aimed to investigate racial disparities in NET outcomes. Patients who had a diagnosis of neuroendocrine tumor between 2014 and 2022 were identified and analyzed in this retrospective chart analysis, with race determined as Caucasian (CA) or Black African American (BAA). Histology was stratified as high grade or those without high grade histology. Grade of tumor was identified as well differentiated, moderately or poorly differentiated, and other/unknown. Log-rank test was conducted to compare the survival curves between CA and AA groups. Cox proportional hazards model was built to adjust for potential confounders, including age at diagnosis and gender (if applicable) while comparing racial disparities. The CA vs. AA hazard ratio (HR) and p-values were calculated. Among the 655 patients analyzed, 63.4% were Caucasian (CA) and 36.6% were Black African American (BAA). The average age at diagnosis across the cohort was 61.5 years. The gender distribution was approximately equal, with 50.2% females and 49.8 % males. High-grade histology was identified in 114 patients, of whom 28.1% were BAA and 71.9% were CA. Within this subgroup, males were more prevalent than females (61.4% vs. 38.6%). Overall survival (OS) for CA patients with high-grade histology was 57.4 months, compared to 67.5 months for BAA patients (p=0.7). Additionally, no statistically significant difference in OS was observed between males and females with high-grade histology (60.8 months vs. 68.1 months, respectively; p=0.3). Analysis of tumor grade revealed that well- differentiated tumors were present in 122 patients (18.63%). Among these patients, there was no statistically significant difference in survival between BAA and CA. The primary tumor site was the colon in 89 patients (13.6%), with 77.5% being CA and 22.5% BAA. Pancreatic tumors were present in 119 patients (18.2%), with 72% being CA and 28% BAA. The next most common primary sites were the small intestine (24.9%), rectum (17.6%), and stomach (9.9%). In comparing survival outcomes between racial groups, CA patients had a significantly worse OS (76.9 months) compared to BAA patients (84.6 months) (p=0.05). Regardless of race, females demonstrated better survival (84.2 months) compared to males (75.7 months) (p=0.04). In our retrospective analysis, Caucasian (CA) patients had worse overall survival (OS) than Black African American (BAA) patients, likely due to a higher proportion of CA patients with high- grade histology and primary tumors in the colon. Females showed better OS than males across all subtypes. The reasons for the higher incidence of worse histology in CA patients are unclear. Larger studies are needed to confirm these findings, understand racial disparities, and develop strategies to mitigate them.

Citation Format: Radhika Gutta, Wan-Ting su, Ruicond She, Muhammad Shahid, Gazala Khan. Real world treatment patterns and patient outcomes of neuroendocrine tumors: A single institution study [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr A070.