Impact of non-metropolitan residence on survival for gastric neuroendocrine tumors.

BACKGROUND

Gastric neuroendocrine tumors (NETs) treated at academic centers are associated with improved survival. However, the impact of location of residence remains unclear. Here, we evaluated outcomes based on metropolitan or non-metropolitan residence.

METHODS

The National Cancer Database (NCDB) was accessed to identify adult patients diagnosed with invasive gastric NETs from 2004 to 2019.

RESULTS

Of 14665 gastric NETs patients, 13 ​% (n ​= ​1933) were from non-metropolitan areas. On multivariable analysis, non-metropolitan residence was associated with reduced survival (HR 1.13, p ​= ​0.007). Patients in non-metropolitan areas had a decreased OS with earlier clinical stages 1-2 (HR 1.40, p ​= ​0.011), with higher grades 3-4 tumors (HR 1.26, p ​= ​0.008), or when undergoing surgical resection (HR 1.19, p ​= ​0.01); survival was equivalent for later stage 3-4 tumors and earlier grades 1-2 tumors.

CONCLUSIONS

Non-metropolitan residence conferred an independent survival disadvantage for all gastric NET patients, especially in early stage or high grade tumors and upon surgical resection. Future research should explore causative factors and possible interventions.