{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T16:44:17Z","timestamp":1791996257219,"version":"4.4.0"},"reference-count":0,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T00:00:00Z","timestamp":1791936000000},"content-version":"am","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n The incidence of gastro-entero-pancreatic neuroendocrine neoplasms (GEP-NENs) has increased, alongside novel therapies and care models. Whether these advances translated into improved survival is unclear.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n Population-based retrospective cohort study of GEP-NENs between 2000\u20132019. Overall survival (OS) was analyzed using time-to-event methods. Restricted cubic splines assessed non-linear associations between diagnosis year and hazards of death; multivariable Cox regression adjusted for age, sex, primary site, and metastatic status.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Among 9,420 patients, 5-year OS was 75.8% overall, 88.8% for non-metastatic disease, and 57.0% for metastatic disease. Mortality risk declined in more recent years, with diagnoses in 2013\u20132019 associated with lower hazards of death (adjusted HR 0.91, 95%CI 0.83\u20130.99). Improvements were confined to non-metastatic disease and to pancreas, stomach, and rectal primaries.<\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n OS has modestly improved over two decades, largely reflecting stage migration rather than clear therapeutic gains. Advances that meaningfully improve survival in advanced GEP-NENs are needed.<\/jats:p>\n <\/jats:sec>","DOI":"10.1093\/jncics\/pkag111","type":"journal-article","created":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T11:47:38Z","timestamp":1791460058000},"source":"Crossref","is-referenced-by-count":0,"title":["Survival over two decades in neuroendocrine neoplasms care"],"prefix":"10.1093","author":[{"given":"Julie","family":"Hallet","sequence":"first","affiliation":[{"name":"Susan Leslie Clinic for Neuroendocrine Tumors, Odette Cancer Centre \u2013 Sunnybrook Health Sciences Centre , Toronto, Ontario,","place":["Canada"]},{"name":"University of Toronto Department of Surgery, , Toronto, Ontario,","place":["Canada"]},{"name":"Evaluative Clinical Sciences , , Toronto, Ontario,","place":["Canada"]},{"name":"Sunnybrook Research Institute , , Toronto, Ontario,","place":["Canada"]},{"name":"Cancer program, ICES , Toronto, Ontario,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L\u00e9amarie","family":"Meloche-Dumas","sequence":"additional","affiliation":[{"name":"University of Toronto Department of Surgery, , Toronto, Ontario,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlotta","family":"Sarzo","sequence":"additional","affiliation":[{"name":"Vita-Salute San Raffaele University , Milan,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica","family":"Armah","sequence":"additional","affiliation":[{"name":"Evaluative Clinical Sciences , , Toronto, Ontario,","place":["Canada"]},{"name":"Sunnybrook Research Institute , , Toronto, Ontario,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Ding","sequence":"additional","affiliation":[{"name":"Evaluative Clinical Sciences , , Toronto, Ontario,","place":["Canada"]},{"name":"Sunnybrook Research Institute , , Toronto, Ontario,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wing","family":"Chan","sequence":"additional","affiliation":[{"name":"Cancer program, ICES , Toronto, Ontario,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simron","family":"Singh","sequence":"additional","affiliation":[{"name":"Susan Leslie Clinic for Neuroendocrine Tumors, Odette Cancer Centre \u2013 Sunnybrook Health Sciences Centre , Toronto, Ontario,","place":["Canada"]},{"name":"Evaluative Clinical Sciences , , Toronto, Ontario,","place":["Canada"]},{"name":"Sunnybrook Research Institute , , Toronto, Ontario,","place":["Canada"]},{"name":"Cancer program, ICES , Toronto, Ontario,","place":["Canada"]},{"name":"University of Toronto Department of Medicine, , Toronto, Ontario,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,10,14]]},"container-title":["JNCI Cancer Spectrum"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/jncics\/advance-article-pdf\/doi\/10.1093\/jncics\/pkag111\/71947648\/pkag111.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jncics\/advance-article-pdf\/doi\/10.1093\/jncics\/pkag111\/71947648\/pkag111.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T15:45:59Z","timestamp":1791992759000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jncics\/advance-article\/doi\/10.1093\/jncics\/pkag111\/8916539"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,14]]},"references-count":0,"URL":"https:\/\/doi.org\/10.1093\/jncics\/pkag111","relation":{},"ISSN":["2515-5091"],"issn-type":[{"value":"2515-5091","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,14]]},"article-number":"pkag111"}}