Gastric Neuroendocrine Tumor Treatment and Survival Outcome Depends on Facility Type

• Published in: The American surgeon 2023-11, Vol.89 (11), p.4334-4343
• Main Authors: Platoff, Rebecca M., Lou, Johanna, Bush, Kathryn, Zhu, Clara, Spitz, Elizabeth, Gaughan, John P., Atabek, Umur, Spitz, Francis, Hong, Young K
• Format: Article
• Language: English
• ISSN: 0003-1348; 1555-9823
• DOI: 10.1177/00031348221109460

Background Gastric neuroendocrine tumors (gNETs) are rare cancers for which surgery may improve survival. We aim to determine if facility type affects treatment and survival outcomes. Methods The NCDB was queried for patients with gNET from 2004-2016 and stratified into Academic/Research Program (ARP), Community Cancer Program (CCP), Comprehensive Community Cancer Program (CCCP), or Integrated Network Cancer Program (INCP). Overall survival along with clinical and demographic features was compared. Results Median survival was improved in patients treated at an academic program: 137.3 months versus 88.0, 96.3, and 100.2 for CCP, CCCP, INCP, respectively (P < .0001). Patients treated at academic centers were more likely to have surgery (64.2% vs 59.1%, 57.5%, 51.4%, P < .0001). After propensity matching for age, race, grade, stage, insurance status, and comorbidity score, survival benefit from treatment at an academic center remained (P = .03), particularly for patients undergoing surgery (P < .0001) and chemotherapy (P = .04). Conclusion Patients with gNET treated at an academic hospital had improved median survival after propensity matching and may benefit from treatment at academic rather than community medical centers.