Cardiovascular Mortality Risk among Patients with Gastroenteropancreatic Neuroendocrine Neoplasms: A Registry-Based Analysis

BACKGROUND: This research is aimed to explore mortality patterns and quantitatively assess the risks of cardiovascular mortality (CVM) in patients with primary gastroenteropancreatic neuroendocrine neoplasms (GEP-NENs). METHODS: We extracted data from the Surveillance, Epidemiology, and End Results (SEER) database for patients diagnosed with GEP-NENs between 2000 and 2015. The standardized mortality ratio (SMR) and the absolute excess risk were obtained based on the reference of the general US population. The cumulative incidence function curves were constructed for all causes of death. Predictors for CVM were identified using a multivariate competing risk model. RESULTS: Overall, 42027 patients were enrolled from the SEER database, of whom 1598 (3.8%) died from cardiovascular disease (CVD). The SMR for CVM was 1.20 (95% CI: 1.14-1.26) among GEP-NEN patients. The cumulative mortality of CVD was the lowest among all causes of death, including primary cancer, other cancer, and other noncancer diseases. Furthermore, age at diagnosis, race, Hispanic origin, sex, marital status, year of diagnosis, grade, education level, region, SEER stage, primary site, surgery, and chemotherapy were identified as independent predictors of CVM in GEP-NEN patients. CONCLUSIONS: GEP-NEN patients have a significantly increased risk of CVM relative to the general population. Cardioprotective interventions might be considered a preferred method for these patients.