Neuroendocrine tumors: Real-world evidence from a national cancer institute in Panama.

Abstract

e16324 Background: Neuroendocrine tumors (NETs) are rare and heterogeneous malignancies with limited epidemiologic data from Central America. This study describes demographic patterns, tumor characteristics, metastatic burden, and survival outcomes among patients with NETs treated at the National Cancer Institute of Panama. Methods: We conducted a retrospective observational study of patients with histologically confirmed NETs managed between 2016 and 2023. The protocol received institutional ethics approval before data extraction. Overall survival (OS), defined from histologic diagnosis to death or last follow-up, was the primary endpoint. Eligible patients were adults > 18 years with pathologically or immunohistochemically confirmed NET. The primary endpoint was overall survival (OS). Survival was estimated using the Kaplan–Meier method and evaluated across age groups, grade, and anatomical site. Results: A total of 340 patients with NETs were identified. Mean age at diagnosis was 59 years, and females comprising 56.2% of the cohort. Metastatic disease at presentation was observed in 46.8% of cases. Tumor grade distribution was 48.8% G1, 21.8% G2, and 27.1% G3 tumors. The most common primary sites were colorectal (17.6%), lung (14.4%), pancreas (13.8). Median OS was 43 months, with a mean survival of 50 months. Survival differed by age group, with 5-year OS of 68.9% ( < 40 years), 44.5% (40–59 years), 41.6% (60–80 years), and 11.7% ( > 80 years). OS also varied by tumor grade, with 5-year OS of 75.6% for G1 tumors, 27.7% for G2, and 13.7% for G3. Survival by primary site showed the highest 5-year OS in appendiceal (92.3%) and breast NETs (88.0%), followed by small bowel (64.8%), duodenum (63.5%), stomach (54.9%), and colorectal tumors (49.1%), while lung (31.6%), pancreatic (26.9%), indeterminate (23.5%), and other sites (23.4%) demonstrated the poorest outcomes. Conclusions: This real-world cohort highlights a substantial burden of neuroendocrine tumors in Panama, characterized by a high proportion of metastatic disease at diagnosis and marked heterogeneity in survival across age groups, tumor grade, and primary site. Favorable outcomes observed in low-grade and appendiceal tumors contrast with the markedly poor survival of high-grade, pancreatic, and elderly patients. These findings underscore the need for earlier detection, standardized diagnostic pathways, and strengthened registry-based strategies to inform and improve NET care in Latin America.