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Health-Related Quality of Life in Patients with Small Intestine Neuroendocrine Tumours.
Neuroendocrinology 2018 October 6
BACKGROUND: The prevalence of small intestine neuroendocrine tumours (SI-NETs) is increasing. Disease progression is often slow and treatment options and long-term survival rates have improved, but little is known about health-related quality of life (HRQoL) in these patients. <br>Objective: To assess HRQoL and its predictors in SI-NET patients receiving contemporary treatments. <br>Methods: We measured HRQoL with 15D and SF-36 questionnaires in 134 SI-NET patients and compared the 15D results to those of age- and gender-standardized general population (n = 1153). In the patients, we studied impact of treatments, Ki67, liver metastases, circulating tumour markers, comorbidities and/or socioeconomic factors on HRQoL with linear regression analysis. <br>Results: Mean disease duration of the patients was 81 (4-468) months, 91% had metastatic disease and 79% received somatostatin analog treatment. Hepatic tumour load was 0% in 44.8%, <10-25% in 44.0%, and >25% in 11.2%, respectively. Mean fP-CgA and S-5HIAA concentrations were 15 (1.3-250) nmol/l and 344 (24-7470) nmol/l, respectively. Overall HRQoL was significantly impaired in patients compared to controls (15D scores 0.864±0.105 vs 0.905±0.028, p<0.001). SI-NET patients scored worse on 9 of 15 dimensions (sleep, excretion (ie bladder and bowel function), depression, distress, vitality, sexual activity (p< 0.001), breathing, usual activities, and discomfort and symptoms (p< 0.01-0.05). SF-36 scores were impaired and highly correlated with 15D scores (p<0.001). HRQoL was impaired in patients with (n=85) compared to patients without (n=49) impaired excretion (0.828 vs 0.933, p<0.001). In the patient group, number of medications predicted impaired HRQoL. <br>Conclusions: Despite contemporary treatments, SI-NET patients have severely impaired HRQoL, including diarrhea, sleep, depression, vitality and sexual activity. <br>.
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