Clinicopathologic characteristics and survival outcomes of gastroenteropancreatic neuroendocrine neoplasms in Peru: A 15-year retrospective cohort study
- 1Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru
- 2Escuela de Medicina Humana, Universidad Privada San Juan Bautista, Lima, Peru
- 3Universidad Científica del Sur, Lima, Peru
Abstract
Introduction: Incidence of gastroenteropancreatic neuroendocrine neoplasms (GEP-NENs) has increased globally; however, data from Latin America remain scarce. This study aimed to describe the sociodemographic and clinicopathologic characteristics, treatment modalities, survival outcomes, and prognostic factors of GEP-NENs in a 15-year single-center cohort at a national referral cancer center in Lima, Peru. Materials and methods: We conducted a retrospective, hospital-based cohort study. Patients diagnosed with GEP-NENs at the Instituto Nacional de Enfermedades Neoplásicas (INEN) were included from 2009 to 2024, and tumors were classified according to the 2019 WHO Classification of GEP-NENs. Overall survival (OS) was estimated using Kaplan-Meier curves and compared using the log-rank test. Prognostic factors were identified through Cox proportional hazards models. Results: Three hundred sixty-eight patients were included. The median age at diagnosis was 57 years, with a female predominance (56.2%). Most patients presented with an ECOG performance status of 0–1 (96.5%), and among patients with available disease-extent information, 64.7% had non-metastatic disease. The majority of tumors were well-differentiated (neuroendocrine tumors [NETs]) (84.2%), while 15.8% were poorly differentiated (neuroendocrine carcinomas [NECs]). The most common primary tumor sites included the rectum (39.1%), stomach (19.8%), and pancreas (18.8%). With a median follow-up of 61.9 months, the 5-year OS rate was 52%. NETs exhibited longer OS than NECs, with 5-year OS rates of 65% and 8%, respectively (log-rank p < 0.001). In the multivariable analysis, metastatic disease (aHR = 2.61, 95% CI: 1.63–4.20; p < 0.001) and poorly differentiated histology (aHR: 4.36, 95% CI: 2.59–7.31; p < 0.001) were independently associated with worse overall survival, whereas surgery (aHR: 0.25, 95% CI: 0.15–0.41; p < 0.001) and systemic treatment (aHR: 0.53, 95% CI: 0.31–0.92; p = 0.024) were associated with improved overall survival. Conclusion: Our findings demonstrate that GEP-NENs represent a highly heterogeneous group of neoplasms with substantial variability in clinicopathological characteristics and survival outcomes. Most patients in our cohort had well-differentiated NETs and favorable long-term survival. These findings support the need for comprehensive national registries and multicenter collaborative studies to validate our results and better characterize GEP-NENs in underrepresented Latin American populations.
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BibTeX
@article{cruzdiaz2026clinicopathologic,
title = {{Clinicopathologic characteristics and survival outcomes of gastroenteropancreatic neuroendocrine neoplasms in Peru: A 15-year retrospective cohort study}},
author = {Wagner Eduardo Cruz-Diaz and Juan Haro-Varas and Daniel Enriquez-Vera and Gabriel De la Cruz Ku and Nattaly Torres-Valdivia and Víctor Paitán Amaro and Alexandra Saavedra and Alejandro Merubia and Angela Leonardo Carbajal and Jackeline Macetas Núñez and Eder Veramendi Cabana and Cristian Pacheco Román and Mónica Calderón Anticona and Tatiana Vidaurre Rojas and Victor Castro-Oliden},
journal = {PLOS One},
year = {2026},
month = nov,
doi = {10.1371/journal.pone.0361867},
url = {https://doi.org/10.1371/journal.pone.0361867},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Clinicopathologic characteristics and survival outcomes of gastroenteropancreatic neuroendocrine neoplasms in Peru: A 15-year retrospective cohort study
AU - Wagner Eduardo Cruz-Diaz
AU - Juan Haro-Varas
AU - Daniel Enriquez-Vera
AU - Gabriel De la Cruz Ku
AU - Nattaly Torres-Valdivia
AU - Víctor Paitán Amaro
AU - Alexandra Saavedra
AU - Alejandro Merubia
AU - Angela Leonardo Carbajal
AU - Jackeline Macetas Núñez
AU - Eder Veramendi Cabana
AU - Cristian Pacheco Román
AU - Mónica Calderón Anticona
AU - Tatiana Vidaurre Rojas
AU - Victor Castro-Oliden
PY - 2026
DA - 2026/11/05
JO - PLOS One
DO - 10.1371/journal.pone.0361867
UR - https://doi.org/10.1371/journal.pone.0361867
AB - Introduction: Incidence of gastroenteropancreatic neuroendocrine neoplasms (GEP-NENs) has increased globally; however, data from Latin America remain scarce. This study aimed to describe the sociodemographic and clinicopathologic characteristics, treatment modalities, survival outcomes, and prognostic factors of GEP-NENs in a 15-year single-center cohort at a national referral cancer center in Lima, Peru. Materials and methods: We conducted a retrospective, hospital-based cohort study. Patients diagnosed with GEP-NENs at the Instituto Nacional de Enfermedades Neoplásicas (INEN) were included from 2009 to 2024, and tumors were classified according to the 2019 WHO Classification of GEP-NENs. Overall survival (OS) was estimated using Kaplan-Meier curves and compared using the log-rank test. Prognostic factors were identified through Cox proportional hazards models. Results: Three hundred sixty-eight patients were included. The median age at diagnosis was 57 years, with a female predominance (56.2%). Most patients presented with an ECOG performance status of 0–1 (96.5%), and among patients with available disease-extent information, 64.7% had non-metastatic disease. The majority of tumors were well-differentiated (neuroendocrine tumors [NETs]) (84.2%), while 15.8% were poorly differentiated (neuroendocrine carcinomas [NECs]). The most common primary tumor sites included the rectum (39.1%), stomach (19.8%), and pancreas (18.8%). With a median follow-up of 61.9 months, the 5-year OS rate was 52%. NETs exhibited longer OS than NECs, with 5-year OS rates of 65% and 8%, respectively (log-rank p < 0.001). In the multivariable analysis, metastatic disease (aHR = 2.61, 95% CI: 1.63–4.20; p < 0.001) and poorly differentiated histology (aHR: 4.36, 95% CI: 2.59–7.31; p < 0.001) were independently associated with worse overall survival, whereas surgery (aHR: 0.25, 95% CI: 0.15–0.41; p < 0.001) and systemic treatment (aHR: 0.53, 95% CI: 0.31–0.92; p = 0.024) were associated with improved overall survival. Conclusion: Our findings demonstrate that GEP-NENs represent a highly heterogeneous group of neoplasms with substantial variability in clinicopathological characteristics and survival outcomes. Most patients in our cohort had well-differentiated NETs and favorable long-term survival. These findings support the need for comprehensive national registries and multicenter collaborative studies to validate our results and better characterize GEP-NENs in underrepresented Latin American populations.
SN - 1932-6203
ER -