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Rachel Darwin, Senior Manager, Public Relations, 2676226624

JNCCN Study Reveals Neuroendocrine Tumor Mortality Patterns to Inform Treatment Decisions

Population–based cohort study from Canada is first to describe patterns of mortality, both cancer-related and otherwise, for people with different types of NETs.

JNCCN Cover, August 2021PLYMOUTH MEETING, PA [August 26, 2021] — Among all patients with neuroendocrine tumors (NETs), the risk of dying of cancer was higher than that of dying of other causes, but mortality varies by primary tumor site, according to a new study published in the August 2021 issue of JNCCN—Journal of the National Comprehensive Cancer Network. It is the first population-based cohort study to describe factors associated with cancer-specific death after a NET diagnosis.

“Neuroendocrine tumors are very unique in that they are often slow growing indolent cancers. They have very heterogenous behaviors. While some metastatic tumors can threaten patients’ survival, other localized tumors do not. Therefore, it was important to understand cause of death and the exact burden of cancer on mortality in different sub-groups of patients with NETs,” said lead author Julie Hallet, MD, MSc, University of Toronto.

“Our results show that some patients with non-metastatic NETs are more likely to die of other causes than NET. This is crucial to inform patients and make decisions regarding treatment. It is important to make sure that treatment does not present a higher risk than the NET itself. For example, small pancreas, stomach or rectal NETs can be safely monitored.”

The retrospective study of 8,607 patients whose health data were stored at ICES, the not-for-profit research institute in Toronto, Canada, found that the highest risks of cancer-specific death occurred in patients with bronchopulmonary and pancreatic NETs.  For non-metastatic gastric, small intestine, colonic, and rectal NETs, the risk of non-cancer death exceeded that of cancer-specific deaths. Advancing age, higher material deprivation, and metastases were associated with higher hazard ratios of cancer-specific mortality; while being female and having a higher comorbidity burden were associated with a higher proportion of cancer-unrelated death, according to the researchers.

“This article sheds an important light on the complex issue of predicting long term survival and the factors associated with it in NETs,” said Whitney S. Goldner, MD, Professor in the Division of Diabetes, Endocrinology, and Metabolism at the Fred & Pamela Buffett Cancer Center; and Vice-Chair of the NCCN Guidelines Panel for Neuroendocrine Tumors.

“NETs are a very heterogeneous group of malignancies, so they require individualized treatment recommendations for each primary tumor site. It is insightful to learn about the different patterns of both cancer and non-cancer specific mortality specific to primary tumor site as well as other contributing factors. This article will be helpful to inform future guidelines regarding monitoring and treatment of different NETs and enable providers to provide NET site-specific counseling.”

Researchers also noted that examination of factors associated with cancer-specific and non cancer-related death showed that efforts to address cancer-specific death in NETs “should include special considerations for older adults and socioeconomically deprived patients to ensure they can access and receive care during their cancer journey.”

The study appears in the August issue of JNCCN. This issue of the journal also includes the announcement of a new impact factor of 11.908 for the past year. That figure has grown steadily since 2017, when it was at 6.471. The impact factor of an academic journal is a scientometric index calculated by Clarivate that reflects the yearly average number of citations of articles published in the journal during the previous two years. With the current impact factor, JNCCN ranks 23rd of 331 oncology journals, putting it in the top 7%.

To read the entire study, visit Complimentary access to “Risk of Cancer-Specific Death for Patients Diagnosed with Neuroendocrine Tumors: A Population –Based Analysis” is available until November 10, 2021. 

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About JNCCN—Journal of the National Comprehensive Cancer Network
More than 25,000 oncologists and other cancer care professionals across the United States read JNCCN—Journal of the National Comprehensive Cancer Network. This peer-reviewed, indexed medical journal provides the latest information about innovation in translational medicine, and scientific studies related to oncology health services research, including quality care and value, bioethics, comparative and cost effectiveness, public policy, and interventional research on supportive care and survivorship. JNCCN features updates on the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®), review articles elaborating on guidelines recommendations, health services research, and case reports highlighting molecular insights in patient care. JNCCN is published by Harborside. Visit To inquire if you are eligible for a FREE subscription to JNCCN, visit Follow JNCCN on Twitter @JNCCN.

About the National Comprehensive Cancer Network

The National Comprehensive Cancer Network® (NCCN®) is a not-for-profit alliance of leading cancer centers devoted to patient care, research, and education. NCCN is dedicated to improving and facilitating quality, effective, efficient, and accessible cancer care so patients can live better lives. The NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) provide transparent, evidence-based, expert consensus recommendations for cancer treatment, prevention, and supportive services; they are the recognized standard for clinical direction and policy in cancer management and the most thorough and frequently-updated clinical practice guidelines available in any area of medicine. The NCCN Guidelines for Patients® provide expert cancer treatment information to inform and empower patients and caregivers, through support from the NCCN Foundation®. NCCN also advances continuing education, global initiatives, policy, and research collaboration and publication in oncology. Visit for more information and follow NCCN on Facebook @NCCNorg, Instagram @NCCNorg, and Twitter @NCCN.