Characteristics and Survival of Patients With Colonic Compared to Rectal Neuroendocrine Tumors: A SEER Registry Analysis
Samantha Sipe, Christopher Lopez, Sameh Hany Emile, Abel Abraham, James Burns, Anjelli Wignakumar, Steven D. WexnerABSTRACT
Introduction
Colon and rectal neuroendocrine tumors (NETs) have varying disease behaviors, presentations, and outcomes. Rectal NETs are detected early; colonic NETs present later and more aggressively. We compared demographic, tumor, treatment, and survival characteristics of colonic versus rectal NETs.
Methods
This retrospective cohort study used SEER data (2000–2022) to identify adults with colonic or rectal NETs. Demographic, tumor, and treatment characteristics were compared by tumor site. Five‐year overall survival (OS) and cancer‐specific survival (CSS) were analyzed using Kaplan–Meier statistics and multivariable Cox proportional hazards regression. Additional site‐specific analyses evaluated stage and treatment patterns by race, ethnicity, and household income.
Results
Twenty‐four percent of 30 246 patients had colonic NETs, and 76.0% had rectal NETs. Rectal NET patients were younger (55.7 vs. 62.9 years, p < 0.001) and more often Black, Asian, or Hispanic. Colonic NETs were more frequently poorly differentiated (43.9% vs. 7.0%), larger (median 30 vs. 5 mm), and more likely to have liver metastases (27.7% vs. 3.7%). Rectal NETs underwent local excision (92.1%), colonic NETs required colectomy (72.3%). Rectal NETs demonstrated higher 5‐year OS (88.8% vs. 55.8%) and CSS (93.8% vs. 58.2%, p < 0.001). Stage III colonic NETs had higher CSS than rectal NETs (67.3% vs. 53.5%, p < 0.001).
Conclusion
Colonic and rectal NETs have distinct clinicopathologic profiles, treatment patterns, and stage‐specific outcomes. These findings support site‐specific evaluation while emphasizing the importance of stage and tumor biology in prognosis.