Independence Valued Over Survival for Neuroendocrine Tumor Patients
There is a trend among patients with neuroendocrine tumors to value their independence over their survival. However, there are many factors that come into play when making this decision. Here is a brief look at some of the issues that you should consider.
Background
Neuroendocrine tumors (NETs) are rare malignancies that affect the integumentary system, aerodigestive and genitourinary systems. They have heterogeneous biological behavior and have variable prognosis. Several factors have been reported to influence survival.
The majority of patients with neuroendocrine tumors are operated with curative intent. However, some NETs have a slow growth rate, and they may be discovered during staging other tumors. In addition, there is an increased risk of developing a second primary malignancy. Although the cause of these tumors is unknown, some genetic syndromes have been associated with them.
Prognosis for NENs has improved over time. However, many studies are limited by inconsistent follow-up. Some of the factors that affect survival include the type of tumor, its grade, and the extent of the lymph node metastasis. This study aimed to better understand the relationship between the presence of metastases and the disease-free survival of patients with neuroendocrine tumors.
To predict the 5-year survival rate of neuroendocrine tumor patients, a model was developed using five factors: tumor differentiation, recurrence, lymphatic metastasis, and number of tumor metastatic sites. Patients with two or more metastatic sites had a longer overall survival than those with only one.
Methods
Neuroendocrine tumors (NETs) have a wide range of prognosis. These neoplasms are associated with numerous complications and often lead to extensive health care use. They are heterogeneous malignancies characterized by nonspecific symptoms and high rates of diagnostic delays.
In order to improve the understanding of the prognosis of NET patients, a large international patient survey was conducted. This study gathered data from more than 900 patients in multiple countries. It was designed to identify unmet needs and enhance awareness of the disease.
A nomogram model was developed to estimate the 5-year survival rate of neuroendocrine tumor patients. The model was constructed based on a number of factors including tumor differentiation, lymphatic metastasis, and number of tumor metastatic sites.
As a result, the nomogram was found to be able to accurately predict the survival probability of patients with a neuroendocrine tumor. For each case, a calibration curve was developed to estimate the probability of patient survival at 5 years.
Results
Neuroendocrine tumors (NETs) are heterogeneous malignancies that have nonspecific symptoms and prognosis. They are often diagnosed during acute surgery for intestinal obstruction or segmental small bowel ischemia. Despite their rarity, they have significant impact on patients’ lives. As a result, the International Neuroendocrine Cancer Alliance partnered with Novartis Pharmaceuticals to conduct the first global survey. This study aimed to provide a better understanding of the disease’s clinical and treatment aspects.
To develop a prediction model, patients were grouped according to tumor type, stage and gender. The variables used to construct a prediction model included the number of metastases, international normalized ratio, tumor differentiation, lymphatic metastasis and peptide receptor radionuclide therapy. These variables were then used in multivariate analyses.
The results of this large survey demonstrate the significant burden of NETs on patients’ lives and the need to improve patient awareness and the use of resources. More targeted diagnostic work up could lead to improved outcomes.
Overall survival after surgery was significantly longer in patients with metastatic disease. Survival is dependent on the type of tumor and its origin. In particular, patients with gastrointestinal NETs have a higher risk of developing a second primary malignancy. Surgical resection is still the preferred approach in these cases.
Discussion
Neuroendocrine neoplasms are rare malignancies that affect the integumentary, aerodigestive, genitourinary, or gastrointestinal systems. They may be classified as poorly differentiated or well-differentiated, depending on their histological characteristics.
The incidence of neuroendocrine tumors has been increasing in recent years, especially for the GI tract. However, there is little information on the long-term survival of these patients. This may be because most studies are limited by the retrospective nature of their data.
A study of patients with advanced neuroendocrine tumors found that the majority of them prioritized quality of life over survival. Furthermore, many patients would tolerate adverse effects in exchange for better QOL in the future.
In addition to survival, patients also rated independence as a higher priority. They also ranked improving pain, fatigue, dizziness, and shortness of breath as important outcomes.
These outcomes were assessed by using four different survey methods. All scales are based on a score from 0 to 100. For example, a high score means that the patient has a high level of functioning.