{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T19:25:07Z","timestamp":1789500307385,"version":"build-2803163510"},"reference-count":36,"publisher":"MDPI AG","issue":"13","license":[{"start":{"date-parts":[[2023,6,21]],"date-time":"2023-06-21T00:00:00Z","timestamp":1687305600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Improved surgical resection and oncological treatment, or an earlier diagnosis may increase survival in small intestinal neuroendocrine tumours (SI-NETs), but only few studies have examined survival trends. We aimed to examine the trend in overall survival and associated factors in SI-NET patients. All patients with SI-NETs at a regional hospital from June 2005 to December 2021 (n = 242) were identified, and the cohort was divided in half, constituting a first period (until November 2012) and a second period (from November 2012). Disease and treatment characteristics, including European Neuroendocrine Tumour Society (ENETS) stage, surgery, oncological treatment and survival, were recorded. The majority (n = 205 (84.7%)) were treated surgically and surgery was considered curative in 137 (66.8%) patients. Median survival was longer in the second period (9.0 years 95% CI 6.4\u201311.7 in the first period vs. median not reached in the second period, p = 0.014), with 5-year survival rates of 63.5% and 83.5%, respectively. ENETS stage and oncological treatment did not differ between the periods, but factors associated with surgical quality, such as lymph node harvest and resection of multiple SI-NETs, were significantly higher in the second period. Age, ENETS stage, time period and tumour resection were independently associated with survival in a multivariate analysis.<\/jats:p>","DOI":"10.3390\/cancers15133272","type":"journal-article","created":{"date-parts":[[2023,6,22]],"date-time":"2023-06-22T02:09:17Z","timestamp":1687399757000},"page":"3272","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Survival Trends in Patients with Small Intestinal Neuroendocrine Tumours\u2014A Cohort Study in Central Norway"],"prefix":"10.3390","volume":"15","author":[{"given":"Oddry","family":"Folkestad","sequence":"first","affiliation":[{"name":"Department of Gastrointestinal Surgery, St. Olav\u2019s Hospital, Trondheim University Hospital, 7030 Trondheim, Norway"},{"name":"Department of Gastrointestinal Surgery, Vestfold Hospital Thrust, 3103 T\u00f8nsberg, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u00d8yvind","family":"Hauso","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, St. Olav\u2019s Hospital, Trondheim University Hospital, 7030 Trondheim, Norway"},{"name":"Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), 7491 Trondheim, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patricia","family":"Mj\u00f8nes","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, St. Olav\u2019s Hospital, Trondheim University Hospital, 7030 Trondheim, Norway"},{"name":"Department of Pathology, St. Olav\u2019s Hospital, Trondheim University Hospital, 7030 Trondheim, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reidun","family":"Fougner","sequence":"additional","affiliation":[{"name":"Department of Radiology, St. Olav\u2019s Hospital, Trondheim University Hospital, 7030 Trondheim, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hans H.","family":"Wasmuth","sequence":"additional","affiliation":[{"name":"Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), 7491 Trondheim, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5365-9357","authenticated-orcid":false,"given":"Reidar","family":"Fossmark","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, St. Olav\u2019s Hospital, Trondheim University Hospital, 7030 Trondheim, Norway"},{"name":"Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), 7491 Trondheim, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,6,21]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1335","DOI":"10.1001\/jamaoncol.2017.0589","article-title":"Trends in the Incidence, Prevalence, and Survival Outcomes in Patients With Neuroendocrine Tumors in the United States","volume":"3","author":"Dasari","year":"2017","journal-title":"JAMA Oncol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"zraa044","DOI":"10.1093\/bjsopen\/zraa044","article-title":"Time trends in incidence and survival of small intestinal cancer in Sweden","volume":"5","author":"Landerholm","year":"2021","journal-title":"BJS Open"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1500","DOI":"10.1007\/s00268-010-0519-z","article-title":"Epidemiology of small bowel carcinoids in a defined population","volume":"34","author":"Landerholm","year":"2010","journal-title":"World J. Surg."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"2655","DOI":"10.1002\/cncr.23883","article-title":"Neuroendocrine tumor epidemiology: Contrasting Norway and North America","volume":"113","author":"Hauso","year":"2008","journal-title":"Cancer"},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Stensb\u00f8l, A.B., Krogh, J., Holmager, P., Klose, M., Oturai, P., Kjaer, A., Hansen, C.P., Federspiel, B., Langer, S.W., and Knigge, U. (2021). Incidence, Clinical Presentation and Trends in Indication for Diagnostic Work-Up of Small Intestinal and Pancreatic Neuroendocrine Tumors. Diagnostics, 11.","DOI":"10.3390\/diagnostics11112030"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"e13264","DOI":"10.1111\/jne.13264","article-title":"Incidence and prevalence of neuroendocrine neoplasms in Norway 1993\u20132021","volume":"35","year":"2023","journal-title":"J. Neuroendocrinol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"44","DOI":"10.1177\/1457496919874484","article-title":"Primary small intestinal neuroendocrine tumors are highly prevalent and often multiple before metastatic disease develops","volume":"110","author":"Eriksson","year":"2021","journal-title":"Scand. J. Surg."},{"key":"ref_8","first-page":"322","article-title":"Carcinoid tumours. Frequency in a defined population during a 12-year period","volume":"84","author":"Berge","year":"1976","journal-title":"Acta Pathol. Microbiol. Scand. A"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"102197","DOI":"10.1016\/j.canep.2022.102197","article-title":"Incidence and prognosis of patients with small intestinal neuroendocrine tumors in a population based nationwide study","volume":"79","author":"Snorradottir","year":"2022","journal-title":"Cancer Epidemiol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"934","DOI":"10.1002\/cncr.11105","article-title":"A 5-decade analysis of 13,715 carcinoid tumors","volume":"97","author":"Modlin","year":"2003","journal-title":"Cancer"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"3332","DOI":"10.1002\/cncr.25855","article-title":"Neuroendocrine tumors of midgut and hindgut origin: Tumor-node-metastasis classification determines clinical outcome","volume":"117","author":"Jann","year":"2011","journal-title":"Cancer"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1419","DOI":"10.1007\/s00268-011-1296-z","article-title":"Long-term results of surgery for small intestinal neuroendocrine tumors at a tertiary referral center","volume":"36","author":"Norlen","year":"2012","journal-title":"World J. Surg."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1794","DOI":"10.1093\/annonc\/mdq022","article-title":"Incidence, patterns of care and prognostic factors for outcome of gastroenteropancreatic neuroendocrine tumors (GEP-NETs): Results from the National Cancer Registry of Spain (RGETNE)","volume":"21","author":"Capdevila","year":"2010","journal-title":"Ann. Oncol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1295","DOI":"10.1023\/A:1012272314550","article-title":"Epidemiology and survival in patients with carcinoid disease in The Netherlands. An epidemiological study with 2391 patients","volume":"12","author":"Quaedvlieg","year":"2001","journal-title":"Ann. Oncol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"58","DOI":"10.1016\/j.amjsurg.2022.09.053","article-title":"Survival in patients with neuroendocrine tumors of the colon, rectum and small intestine","volume":"225","author":"Keller","year":"2023","journal-title":"Am. J. Surg."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1084","DOI":"10.1080\/00365520903082432","article-title":"Small intestinal neuroendocrine tumors: Prognostic factors and survival","volume":"44","author":"Bergestuen","year":"2009","journal-title":"Scand. J. Gastroenterol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1139","DOI":"10.1002\/ijc.31137","article-title":"Survival in neuroendocrine neoplasms; A report from a large Norwegian population-based study","volume":"142","author":"Aagnes","year":"2018","journal-title":"Int. J. Cancer"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1159\/000443170","article-title":"ENETS Consensus Guidelines Update for Neuroendocrine Neoplasms of the Jejunum and Ileum","volume":"103","author":"Niederle","year":"2016","journal-title":"Neuroendocrinology"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"4656","DOI":"10.1200\/JCO.2009.22.8510","article-title":"Placebo-controlled, double-blind, prospective, randomized study on the effect of octreotide LAR in the control of tumor growth in patients with metastatic neuroendocrine midgut tumors: A report from the PROMID Study Group","volume":"27","author":"Rinke","year":"2009","journal-title":"J. Clin. Oncol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"224","DOI":"10.1056\/NEJMoa1316158","article-title":"Lanreotide in metastatic enteropancreatic neuroendocrine tumors","volume":"371","author":"Caplin","year":"2014","journal-title":"N. Engl. J. Med."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1056\/NEJMoa1607427","article-title":"Phase 3 Trial of (177)Lu-Dotatate for Midgut Neuroendocrine Tumors","volume":"376","author":"Strosberg","year":"2017","journal-title":"N. Engl. J. Med."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1159\/000335629","article-title":"ENETS Consensus Guidelines for the management of patients with neuroendocrine neoplasms from the jejuno-ileum and the appendix including goblet cell carcinomas","volume":"95","author":"Pape","year":"2012","journal-title":"Neuroendocrinology"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"3063","DOI":"10.1200\/JCO.2007.15.4377","article-title":"One hundred years after \u201ccarcinoid\u201d: Epidemiology of and prognostic factors for neuroendocrine tumors in 35,825 cases in the United States","volume":"26","author":"Yao","year":"2008","journal-title":"J. Clin. Oncol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"183","DOI":"10.1001\/jamaoncol.2017.3326","article-title":"Association of a Prophylactic Surgical Approach to Stage IV Small Intestinal Neuroendocrine Tumors with Survival","volume":"4","author":"Daskalakis","year":"2018","journal-title":"JAMA Oncol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"7822","DOI":"10.1245\/s10434-022-12030-0","article-title":"Primary Tumor Resection is Associated with Improved Disease-Specific Mortality in Patients with Stage IV Small Intestinal Neuroendocrine Tumors (NETs): A Comparison of Upfront Surgical Resection Versus a Watch and Wait Strategy in Two Specialist NET Centers","volume":"29","author":"Levy","year":"2022","journal-title":"Ann. Surg. Oncol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1003","DOI":"10.1080\/00365521.2019.1647281","article-title":"Hepatic micrometastases outside macrometastases are present in all patients with ileal neuroendocrine primary tumour at the time of liver resection","volume":"54","author":"Fossmark","year":"2019","journal-title":"Scand. J. Gastroenterol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1186\/s13023-021-01677-9","article-title":"Neuroendocrine liver metastasis from the small intestine: Is surgery beneficial for survival?","volume":"16","author":"Selberherr","year":"2021","journal-title":"Orphanet J. Rare Dis."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"336","DOI":"10.1016\/j.suronc.2020.09.015","article-title":"Survival and disease recurrence in patients operated for small intestinal neuroendocrine tumors at a referral hospital","volume":"35","author":"Folkestad","year":"2020","journal-title":"Surg. Oncol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"e13205","DOI":"10.1111\/jne.13205","article-title":"Association of lymph node metastases, grade and extent of mesenteric lymph node dissection in locoregional small intestinal neuroendocrine tumors with recurrence-free survival","volume":"34","author":"Daskalakis","year":"2022","journal-title":"J. Neuroendocrinol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1109","DOI":"10.1007\/s00268-020-05884-6","article-title":"Prognostic Factors in Curative Resected Locoregional Small Intestine Neuroendocrine Neoplasms","volume":"45","author":"Evers","year":"2021","journal-title":"World J. Surg."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"134","DOI":"10.1001\/jamasurg.2018.3865","article-title":"Prognostic Role of Lymph Node Positivity and Number of Lymph Nodes Needed for Accurately Staging Small-Bowel Neuroendocrine Tumors","volume":"154","author":"Zaidi","year":"2019","journal-title":"JAMA Surg."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1266","DOI":"10.1007\/s11605-022-05269-1","article-title":"Surgical Treatment of Neuroendocrine Tumors of the Terminal Ileum or Cecum: Ileocecectomy Versus Right Hemicolectomy","volume":"26","author":"Li","year":"2022","journal-title":"J. Gastrointest. Surg."},{"key":"ref_33","doi-asserted-by":"crossref","unstructured":"Zhou, Z., Ge, H., Li, Y., Wang, D., and G\u00fcng\u00f6r, C. (2022). Survival effects of primary and metastatic surgical treatment in metastatic small intestinal tumors: A propensity score-matching study. PLoS ONE, 17.","DOI":"10.1371\/journal.pone.0270608"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1695","DOI":"10.1007\/s00268-013-1918-8","article-title":"Resection of at-risk mesenteric lymph nodes is associated with improved survival in patients with small bowel neuroendocrine tumors","volume":"37","author":"Landry","year":"2013","journal-title":"World J. Surg."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1007\/s11605-017-3524-9","article-title":"Optimal Lymphadenectomy in Small Bowel Neuroendocrine Tumors: Analysis of the NCDB","volume":"22","author":"Motz","year":"2018","journal-title":"J. Gastrointest. Surg."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"1808","DOI":"10.1016\/j.ejso.2017.05.016","article-title":"Role of palliative resection of the primary tumour in advanced pancreatic and small intestinal neuroendocrine tumours: A systematic review and meta-analysis","volume":"43","author":"Almond","year":"2017","journal-title":"Eur. J. Surg. Oncol."}],"container-title":["Cancers"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6694\/15\/13\/3272\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T19:58:01Z","timestamp":1760126281000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6694\/15\/13\/3272"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,6,21]]},"references-count":36,"journal-issue":{"issue":"13","published-online":{"date-parts":[[2023,7]]}},"alternative-id":["cancers15133272"],"URL":"https:\/\/doi.org\/10.3390\/cancers15133272","relation":{},"ISSN":["2072-6694"],"issn-type":[{"value":"2072-6694","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,6,21]]}}}