ArticleThe Lancet regional health. Europe2026
Real-world presentation and outcomes of gastroenteropancreatic neuroendocrine neoplasms in Italy: findings from the nationwide Itanet prospective database.
Article in The Lancet regional health. Europe, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: The incidence of gastroenteropancreatic neuroendocrine neoplasms (GEP-NENs) is increasing, but population registries seldom capture detailed clinical data. The Italian Association for Neuroendocrine Tumours (Itanet) established a nationwide prospective database to describe presentation, diagnostic pathways, management, and outcomes of newly diagnosed GEP-NENs in Italy. Methods: This multicentre prospective observational study enrolled 2138 consecutive patients with newly diagnosed GEP-NENs across 38 Italian centres (2019-2024). Clinical, pathological, imaging, and treatment data were prospectively collected and centrally validated. Descriptive and survival analyses were performed; Ki-67 was modelled as a continuous variable. Findings: Median age was 60.6 years, and 55.9% (1195/2138) were male. Tumours were well-differentiated NETs in 90.8% of patients (1942/2138), mainly of pancreatic (41.4%, 886/2138) or ileal (19.7%, 422/2138) origin. Median Ki-67 was 2%. An incidental diagnosis occurred in 58.6% (1254/2138) of cases. Among symptomatic patients, the mean diagnostic delay was 197 days (224 for pancreatic vs 184 for small bowel; p = 0.039). Interpretation: This nationwide prospective study delineates real-world diagnostic and therapeutic patterns of GEP-NENs in Italy, confirms Ki-67 as a continuous prognostic biomarker, and identifies a 15% threshold associated with worse survival, providing a benchmark for outcome assessment and future clinical research. Funding: None.
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