Department of Clinical Medicine and Surgery, University of Naples Federico II, Via Sergio Pansini 5, 80131, Naples, Italy.
Department of Neuroscience, Reproductive Sciences and Dentistry, University of Naples Federico II, Naples, Italy.
J Endocrinol Invest. 2022 Nov;45(11):2193-2200. doi: 10.1007/s40618-022-01872-w. Epub 2022 Jul 22.
Scientific knowledge on health-related quality of life (HRQoL) in patients with neuroendocrine neoplasm (NEN) is still limited and longitudinal assessment of HRQoL over the time in NEN patients are scarce. The current study aimed to assess the role of clinical severity and heterogeneity of NEN, as well as resilience, in the HRQoL of NEN patients over the course of a year.
39 consecutive NEN patients (25 men and 14 women) aged from 29 to 73 years participated in a longitudinal Italian multicentric study. The main outcome measure concerned the severity and heterogeneity of NEN, HRQoL, and resilience.
Over the course of a year, higher levels of the global health (GH) were associated to the absence of distant metastases, while the presence of metastases with higher levels of fatigue, diarrhea, and financial difficulties. Higher levels of resilience are still associated with better GH and lower levels of fatigue, diarrhea, and financial difficulties, but no longer with constipation. Furthermore, patients with gastroenteropancreatic NEN still have higher scores on constipation, but not on GH, fatigue, diarrhea, and financial difficulties. Patients with hereditary NEN continue to have greater GH than those with a sporadic NEN and lower fatigue, diarrhea, and financial difficulties.
These findings showed that the effects of severity and clinical heterogeneity of the NEN on HRQoL may change over time. This evidence should lead clinicians to monitor the HRQoL of NEN patients throughout the course of the disease and psychologists to implement evidence-based resilience interventions.
关于神经内分泌肿瘤（NEN）患者健康相关生活质量（HRQoL）的科学知识仍然有限，并且对 NEN 患者 HRQoL 的纵向评估也很少。本研究旨在评估 NEN 的临床严重程度和异质性以及韧性在 NEN 患者一年中 HRQoL 中的作用。
39 例连续的 NEN 患者（25 名男性和 14 名女性）年龄为 29 至 73 岁，参加了一项意大利多中心的纵向研究。主要的结局指标是 NEN 的严重程度和异质性、HRQoL 和韧性。
在一年的时间里，更高的全球健康（GH）水平与没有远处转移有关，而存在转移则与更高水平的疲劳、腹泻和经济困难有关。更高的韧性水平仍然与更好的 GH 和更低水平的疲劳、腹泻和经济困难相关，但与便秘无关。此外，胃肠胰腺神经内分泌肿瘤患者在便秘方面的评分仍然更高，但在 GH、疲劳、腹泻和经济困难方面则不然。遗传性 NEN 患者的 GH 仍然高于散发性 NEN 患者，疲劳、腹泻和经济困难程度较低。
这些发现表明，NEN 的严重程度和临床异质性对 HRQoL 的影响可能会随时间而变化。这一证据应促使临床医生在疾病过程中监测 NEN 患者的 HRQoL，并促使心理学家实施基于证据的韧性干预措施。
