Gender Differences in Prognosis of Pancreatic Neuroendocrine Tumors: A Retrospective Cohort Study Based on the SEER Database

Introduction While gender is a known prognostic factor for many cancers, its specific role in pancreatic neuroendocrine tumors (PanNETs) survival remains poorly characterized. This study aimed to investigate gender-based differences in PanNETs prognosis using the Surveillance, Epidemiology, and End Results (SEER) database. Methods This retrospective cohort study included patients diagnosed with PanNETs between the years 2000 and 2020, extracted from the SEER database. Propensity score matching (PSM) was applied to mitigate potential selection bias. Overall survival (OS) was evaluated using Kaplan-Meier analysis and multivariable Cox regression. Results Among the 5155 patients included (2814 males, 2341 females), males showed significantly worse OS than females both before (hazard ratio [HR] 1.29, 95% CI 1.14-1.47, P < 0.001) and after (HR 1.19, 95% CI 1.02-1.38, P = 0.026) PSM. Subgroup analyses confirmed a consistent OS advantage for females across most categories. Multivariable analysis identified marital status, age, tumor grade, gender, year of diagnosis, N stage, M stage, and surgical intervention as independent predictors of OS. Similar predictors were found in males, whereas in females, marital status, age, grade, N stage, M stage, and surgery were specifically significant. Conclusions Female patients with PanNETs exhibit superior OS rates. Further research is needed to clarify the biological and clinical mechanisms underlying these gender-related disparities.