Symptom burden and outcomes among patients with early-onset and average-onset neuroendocrine neoplasms
Year: 2025
Type: conference-abstract
Abstract: 237 Background: The incidence of neuroendocrine neoplasms (NENs) is rising, particularly among younger individuals. However, data comparing clinical features and outcomes between early-onset NENs (EO-NENs) and average-onset NENs (AO-NENs) remain limited. Using a large national hospitalizations database, we aimed to compare patient characteristics, symptom burden, and clinical outcomes between these groups. Methods: We identified all hospitalizations involving patients with neuroendocrine neoplasms (NENs) in the National Inpatient Sample (NIS) from 2016 to 2020 using ICD-10 codes. Hospitalizations were stratified into an early-onset cohort (age < 50 years) and a late-onset cohort (age ≥50 years). Demographic characteristics, symptom burden, treatment interventions, and clinical outcomes were extracted and compared between cohorts. Independent sample t-tests were used for continuous variables, and chi-squared tests were used for categorical variables. A p-value of < 0.05 was considered statistically significant. Results: There were 22,555 hospitalizations with EO-NENs (median age 42.0) and 149,470 with AO-NENs (median age 67.0), respectively. The EO-NENs cohort had more females (55.3% vs. 49.3%, p < .001), a lower Charlson Comorbidity Index (CCI) (6.3 vs. 9.7, p < .002), and a greater likelihood of private insurance as primary payer (59.3% vs 28.3%, p < .001)). Hospitalizations for EO-NENs were more commonly associated with tumors of intestinal and thymic origin (p < .001). EO-NENs hospitalizations experienced a substantially higher symptom burden, including more nausea/vomiting (8.6% vs. 4.7%, p < .001), constipation (13.9% vs. 10.8%, p < .001), abdominal pain (1.9% vs 1.3%, p < .001) and anxiety (18.3% vs. 14.0%, p < .001). However, AO-NENs hospitalizations had higher rates of acute complications (heart failure, liver failure, sepsis) and in-hospital mortality (6.2% vs. 4.0%, p < .001). Early-onset hospitalizations underwent more chemotherapy (6.1% vs. 4.2%, p < .001) and surgical resection. Conclusions: We demonstrate significant clinical differences between EO- and AO-NENs, notably a higher symptom burden and relatively favorable outcomes. These data add to a growing body of literature indicating that EO-NENs characterize a clinically distinct subset. These findings underscore the need for age-adapted care pathways and further research into the unique biology that underpins the distinct clinical features of EO-NENs.
Source: JCO Oncology Practice
Institutions: Brooklyn Hospital Center, University at Buffalo, State University of New York, University of Miami, Sylvester Comprehensive Cancer Center, University of Iowa, Roswell Park Comprehensive Cancer Center, Northwell Health, The University of Texas Southwestern Medical Center, University of Iowa Hospitals and Clinics
Language: English
Subfield: Epidemiology
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W4414893179
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