{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T03:30:30Z","timestamp":1777865430034,"version":"3.51.4"},"reference-count":56,"publisher":"Wiley","issue":"21","license":[{"start":{"date-parts":[[2025,11,7]],"date-time":"2025-11-07T00:00:00Z","timestamp":1762473600000},"content-version":"vor","delay-in-days":6,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,11,1]],"date-time":"2025-11-01T00:00:00Z","timestamp":1761955200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100004737","name":"National Health Research Institutes","doi-asserted-by":"publisher","award":["CA\u2010113\u2010PP\u201009"],"award-info":[{"award-number":["CA\u2010113\u2010PP\u201009"]}],"id":[{"id":"10.13039\/501100004737","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004737","name":"National Health Research Institutes","doi-asserted-by":"publisher","award":["CA\u2010113\u2010PP\u201021"],"award-info":[{"award-number":["CA\u2010113\u2010PP\u201021"]}],"id":[{"id":"10.13039\/501100004737","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Medicine"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Lung and small cell neuroendocrine carcinomas (SCCs) are the most common sites and histological types of high\u2010grade neuroendocrine carcinoma (NEC). Comprehensive epidemiological information on NECs is limited. We used the Taiwan Cancer Registry database to analyze the nationwide epidemiology and clinical outcomes of NECs in Taiwan.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We used morphology codes from the International Classification of Diseases for Oncology, third edition (ICD\u2010O\u20103) and ICD codes to identify the histologic type and sites of NECs, respectively. The Kaplan\u2013Meier method was used to estimate the overall survival (OS) of NECs. The risk of NEC death was evaluated using Cox proportional hazards regression analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The incidence of NECs in Taiwan was 3.892 per 100,000 in 2006 and increased to 4.039 per 100,000 in 2021, with the predominant site being the lung and bronchus and the histologic type of SCC. The median OS of all NECs was 8.3\u2009months. Female sex, earlier stage, and later diagnosis (2016\u20132021) were good prognostic factors for the OS of NECs, whereas the histologic type of SCC and large cell neuroendocrine carcinoma, primary sites of the lung and bronchus, esophagus, and unknown primary sites were poor prognostic factors for the OS of NECs. Surgery combined with chemotherapy and\/or radiation therapy resulted in longer survival for stage III\/IV NECs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Differences in the incidence trends and clinical outcomes of NECs suggest different etiologies and heterogeneities of NECs. Further investigations on risk factor identification and novel treatment strategies for NECs are warranted.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/cam4.71369","type":"journal-article","created":{"date-parts":[[2025,11,7]],"date-time":"2025-11-07T13:08:37Z","timestamp":1762520917000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The Epidemiology of Neuroendocrine Carcinomas in Taiwan: A Population\u2010Based Cancer Registry Study"],"prefix":"10.1002","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9581-2778","authenticated-orcid":false,"given":"Yi\u2010Hsin","family":"Yang","sequence":"first","affiliation":[{"name":"National Institute of Cancer Research, National Health Research Institutes  Tainan Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ru\u2010Yu","family":"Huang","sequence":"additional","affiliation":[{"name":"National Institute of Cancer Research, National Health Research Institutes  Tainan Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pei\u2010Yi","family":"Chu","sequence":"additional","affiliation":[{"name":"National Institute of Cancer Research, National Health Research Institutes  Tainan Taiwan"},{"name":"Department of Pathology Show Chwan Memorial Hospital  Changhua Taiwan"},{"name":"Department of Post\u2010Baccalaureate Medicine, College of Medicine National Chung Hsing University  Taichung Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shuen\u2010Ru","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Oncology National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University  Tainan Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeng\u2010Shiun","family":"Du","sequence":"additional","affiliation":[{"name":"Division of Hemato\u2010Oncology, Department of Internal Medicine Kaohsiung Medical University Hospital, Kaohsiung Medical University  Kaohsiung Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5246-5748","authenticated-orcid":false,"given":"Hui\u2010Jen","family":"Tsai","sequence":"additional","affiliation":[{"name":"National Institute of Cancer Research, National Health Research Institutes  Tainan Taiwan"},{"name":"Department of Oncology National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University  Tainan Taiwan"},{"name":"Division of Hemato\u2010Oncology, Department of Internal Medicine Kaohsiung Medical University Hospital, Kaohsiung Medical University  Kaohsiung Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,11,7]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2007.15.4377"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.23736\/S0031\u20100808.22.04602\u2010X"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/MPA.0b013e3181ec124e"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12022\u2010014\u20109313\u2010z"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41379\u2010018\u20100110\u2010y"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12022\u2010022\u201009708\u20102"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ecl.2018.04.008"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.23883"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0062487"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.canep.2019.101598"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12020\u2010017\u20101273\u2010x"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12020\u2010023\u201003649\u20104"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoncol.2024.5937"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.7150\/jca.33367"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cllc.2019.07.011"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm12124126"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.31860"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471\u20102407\u201014\u2010147"},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.21037\/jgo\u201023\u2010905"},{"key":"e_1_2_12_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clgc.2019.11.014"},{"key":"e_1_2_12_22_1","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2016.00148"},{"key":"e_1_2_12_23_1","doi-asserted-by":"publisher","DOI":"10.1590\/S0004\u20102803.202200001\u201010"},{"key":"e_1_2_12_24_1","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.12748"},{"key":"e_1_2_12_25_1","doi-asserted-by":"publisher","DOI":"10.1159\/000488987"},{"key":"e_1_2_12_26_1","doi-asserted-by":"publisher","DOI":"10.1093\/jjco\/hyu211"},{"key":"e_1_2_12_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470\u20102045(23)00444\u20108"},{"key":"e_1_2_12_28_1","doi-asserted-by":"publisher","DOI":"10.1002\/cam4.70608"},{"key":"e_1_2_12_29_1","doi-asserted-by":"publisher","DOI":"10.1002\/cam4.6510"},{"key":"e_1_2_12_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtho.2022.10.002"},{"key":"e_1_2_12_31_1","doi-asserted-by":"publisher","DOI":"10.1080\/17446651.2023.2279540"},{"key":"e_1_2_12_32_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.35281"},{"key":"e_1_2_12_33_1","doi-asserted-by":"publisher","DOI":"10.1136\/tobaccocontrol-2021-056535"},{"key":"e_1_2_12_34_1","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.00618\u20102015"},{"key":"e_1_2_12_35_1","doi-asserted-by":"publisher","DOI":"10.1186\/2162\u20103619\u20104\u20102"},{"key":"e_1_2_12_36_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm11051461"},{"key":"e_1_2_12_37_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2005.04.8595"},{"key":"e_1_2_12_38_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoncol.2022.3395"},{"key":"e_1_2_12_39_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140\u20106736(22)01659\u20102"},{"key":"e_1_2_12_40_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40257\u2010024\u201000885\u2010w"},{"key":"e_1_2_12_41_1","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mdt009"},{"key":"e_1_2_12_42_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12902\u2010022\u201001016\u20104"},{"key":"e_1_2_12_43_1","doi-asserted-by":"publisher","DOI":"10.21037\/tcr\u201023\u2010368"},{"key":"e_1_2_12_44_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598\u2010021\u201002391\u2010z"},{"key":"e_1_2_12_45_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2018.09.006"},{"key":"e_1_2_12_46_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jss.2019.04.034"},{"key":"e_1_2_12_47_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejso.2013.12.020"},{"key":"e_1_2_12_48_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12020\u2010021\u201002959\u20109"},{"key":"e_1_2_12_49_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2000.18.12.2493"},{"key":"e_1_2_12_50_1","doi-asserted-by":"publisher","DOI":"10.1002\/jso.26319"},{"key":"e_1_2_12_51_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoncol.2022.5631"},{"key":"e_1_2_12_52_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1809064"},{"key":"e_1_2_12_53_1","doi-asserted-by":"publisher","DOI":"10.1002\/onco.13752"},{"key":"e_1_2_12_54_1","doi-asserted-by":"publisher","DOI":"10.1158\/1078\u20100432.CCR\u201020\u20103901"},{"key":"e_1_2_12_55_1","doi-asserted-by":"publisher","DOI":"10.1158\/1078\u20100432.CCR\u201019\u20101133"},{"key":"e_1_2_12_56_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtho.2021.02.009"},{"key":"e_1_2_12_57_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.22.02823"}],"container-title":["Cancer Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/cam4.71369","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/cam4.71369","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/cam4.71369","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T06:31:52Z","timestamp":1777530712000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/cam4.71369"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11]]},"references-count":56,"journal-issue":{"issue":"21","published-print":{"date-parts":[[2025,11]]}},"alternative-id":["10.1002\/cam4.71369"],"URL":"https:\/\/doi.org\/10.1002\/cam4.71369","archive":["Portico"],"relation":{},"ISSN":["2045-7634","2045-7634"],"issn-type":[{"value":"2045-7634","type":"print"},{"value":"2045-7634","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11]]},"assertion":[{"value":"2025-01-14","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-10-24","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-11-07","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e71369"}}