{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,23]],"date-time":"2025-12-23T17:11:31Z","timestamp":1766509891350,"version":"3.48.0"},"reference-count":27,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2025,11,28]],"date-time":"2025-11-28T00:00:00Z","timestamp":1764288000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004731","name":"Natural Science Foundation of Zhejiang Province","doi-asserted-by":"publisher","award":["ZCLQ24H2901"],"award-info":[{"award-number":["ZCLQ24H2901"]}],"id":[{"id":"10.13039\/501100004731","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82405039"],"award-info":[{"award-number":["82405039"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Reports"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Neuroendocrine neoplasms (NENs) constitute a heterogeneous group of rare tumors that most commonly originate from the gastrointestinal tract and lungs, with a consistently rising global incidence over recent decades. Hepatobiliary neuroendocrine neoplasms (HB\u2010NENs), defined as primary NENs arising in the liver and biliary tract, are exceedingly uncommon, accounting for less than 0.5% of all NENs. Owing to their low incidence, atypical clinical presentations, and the paucity of large\u2010scale datasets, no distinct World Health Organization (WHO) classification criteria have yet been established for these entities. Epidemiological characteristics and prognostic studies of HB\u2010NENs remain extremely limited. Current prognostic evaluation relies predominantly on the American Joint Committee on Cancer (AJCC) and European Neuroendocrine Tumor Society (ENETS) TNM staging systems, whereas population\u2010level investigations into incidence trends, survival determinants, and individualized predictive tools for HB\u2010NENs are still largely absent.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>To investigate epidemiological trends (1992\u20132020) and prognostic factors associated with overall survival in a nationally representative cohort of patients with hepatobiliary neuroendocrine neoplasms using the Surveillance, Epidemiology, and End Results registry, with subgroup stratification by sex and race. Additionally, we aim to develop a prognostic nomogram integrating significant predictors to quantify individualized survival probabilities for this population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this cohort study, patients diagnosed with hepatobiliary neuroendocrine neoplasms between January 1, 1975, and December 31, 2020, were identified from the Surveillance, Epidemiology, and End Results Program. Related data were used for epidemiologic and survival analysis, as well as the development and validation of a nomogram to predict the overall survival probability of individual hepatobiliary neuroendocrine neoplasms patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The age\u2010adjusted incidence rate of hepatobiliary neuroendocrine neoplasms increased 1.76\u2010fold from 1992 to 2020 (annual percentage change [APC], 2.73; 95% CI, 1.86\u22123.65;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05). Furthermore, the incidence of hepatobiliary neuroendocrine neoplasms in the extrahepatic bile duct increased most significantly (APC, 3.73; 95% CI, 2.03\u22125.46;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05), and the gallbladder also increased most significantly (APC, 3.51; 95% CI, 1.97\u22125.08;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt; 0.05), whereas patients with hepatobiliary neuroendocrine neoplasms in the liver had no significant difference. As for tumor type, the incidence increased in hepatobiliary neuroendocrine carcinomas (APC, 2.93; 95% CI, 1.34\u22124.53;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05) but the incidence was stable in hepatobiliary neuroendocrine tumors. On\u00a0multivariate analyzes, age at diagnosis, race, tumor size, grade, tumor type, tumor stage, and surgery were significantly associated with overall survival for hepatobiliary neuroendocrine neoplasms patients. Furthermore, a nomogram based on significant associated factors (age at diagnosis, race, tumor size, stage, type, grade, chemotherapy and surgery) was constructed to predict the 6\u2010month, 1\u2010year and 2\u2010year survival probability, with the concordance indexes of 0.829 (95% CI, 0.800\u22120.857) for the training cohort and 0.801 (95% CI, 0.745\u22120.857) for the validation cohort.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In this study, the incidence of hepatobiliary neuroendocrine neoplasms has exhibited a persistent upward trend over nearly two decades. Furthermore, this study proposes that a nomogram comprising eight prognostic parameters can effectively quantify the mortality risk in hepatobiliary neuroendocrine neoplasms patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/cnr2.70410","type":"journal-article","created":{"date-parts":[[2025,11,29]],"date-time":"2025-11-29T02:34:48Z","timestamp":1764383688000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Epidemiologic Trends and Factors Associated With Overall Survival for Patients With Hepatobiliary Neuroendocrine Neoplasms in the United States"],"prefix":"10.1002","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-5928-7858","authenticated-orcid":false,"given":"Xinlei","family":"Zhou","sequence":"first","affiliation":[{"name":"The Third Clinical Medical School, the Rehabilitation Medical School Zhejiang Chinese Medical University  Hangzhou China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-1587-6484","authenticated-orcid":false,"given":"Chenxi","family":"Zhou","sequence":"additional","affiliation":[{"name":"The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine)  Hangzhou China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-6753-1628","authenticated-orcid":false,"given":"Yi","family":"Lu","sequence":"additional","affiliation":[{"name":"The Third Clinical Medical School, the Rehabilitation Medical School Zhejiang Chinese Medical University  Hangzhou China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-5627-1483","authenticated-orcid":false,"given":"Shenghao","family":"Lin","sequence":"additional","affiliation":[{"name":"The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine)  Hangzhou China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-1332-5660","authenticated-orcid":false,"given":"Che","family":"Fu","sequence":"additional","affiliation":[{"name":"The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine)  Hangzhou China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-2369-7873","authenticated-orcid":false,"given":"Mengfan","family":"Wei","sequence":"additional","affiliation":[{"name":"School of Medical Technology and Information Engineering Zhejiang Chinese Medical University  Hangzhou China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1441-3899","authenticated-orcid":false,"given":"Leitao","family":"Sun","sequence":"additional","affiliation":[{"name":"The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine)  Hangzhou China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6348-9785","authenticated-orcid":false,"given":"Kaibo","family":"Guo","sequence":"additional","affiliation":[{"name":"Department of Oncology Hangzhou First People's Hospital, Westlake University School of Medicine  Hangzhou China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,11,28]]},"reference":[{"key":"e_1_2_14_2_1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21493"},{"key":"e_1_2_14_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11154-020-09612-2"},{"key":"e_1_2_14_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/his.13975"},{"key":"e_1_2_14_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.lanepe.2022.100510"},{"key":"e_1_2_14_6_1","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2024.1391663"},{"volume-title":"Classification of Tumours of the Digestive System","year":"2019","author":"Arends M. 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