Health-related quality of life, anxiety, depression and impulsivity in patients with advanced gastroenteropancreatic neuroendocrine tumours

Abstract

AIMTo compare health-related quality of life (HRQoL), anxiety, depression, and impulsivity scores in patients with and without carcinoid syndrome (CS), and correlated them with serum 5-hydroxyindoleacetic acid (5-HIAA) levels.METHODSPatients with advanced gastroenteropancreatic neuroendocrine tumours (GEPNET), with and without CS completed HRQoL QLQ-C30 and QLQ-GI.NET21, Hospital Anxiety and Depression Scale (HADS) and Barratt Impulsivity Scale (BIS) questionnaires. Two-sample Wilcoxon test was applied to assess differences in serum 5-HIAA levels, two-sample Mann-Whitney U test for HRQoL and BIS, and proportion test for HADS, between those with and without CS.RESULTSFifty patients were included; 25 each with and without CS. Median 5-HIAA in patients with and without CS was 367nmol/L and 86nmol/L, respectively (P = 0.003). Scores related to endocrine symptoms were significantly higher amongst patients with CS (P = 0.04) and scores for disease-related worries approached significance in the group without CS, but no other statistically-significant differences were reported between patients with and without CS in responses on QLQ-C30 or QLQ-GI.NET21. Fifteen patients (26%) scored ≥ 8/21 on anxiety scale, and 6 (12%) scored ≥ 8/21 on depression scale. There was no difference in median 5-HIAA between those scoring < or ≥ 8/21 on anxiety scale (P = 0.53). There were no statistically significant differences between groups in first or second-order factors (BIS) or total sum (P = 0.23).CONCLUSIONExcepting endocrine symptoms, there were no significant differences in HRQoL, anxiety, depression or impulsivity between patients with advanced GEPNET, with or without CS. Over one quarter of patients had high anxiety scores, unrelated to peripheral serotonin metabolism.

Bone Metabolism and Vitamin D Implication in Gastroenteropancreatic Neuroendocrine Tumors

“…Quality of life is an important measure of patients' perception of the burden of the disease and the impact of the different treatment modalities. Several studies have reported a worse HRQoL in GEP-NET patients compared to matched controls [80,81]. Particularly, NET patients reported poorer physical function, sleep disorders, discomfort, and depression.…”

Clinicopathological Features and Prognosis of Gastric Neuroendocrine Neoplasms

“…Apart from them, supportive therapy cannot be ignored debulking surgery and interventional radiologic techniques to reduce tumors bulk or load, as well as systemic medical treatment options to manage or prevent hypersecretion syndromes and treatment-related side effects. What's more, supportive therapy also encompasses psychosocial support, expert nursing, nutritional support, and management of cancerrelated pain [26,27].…”

Update on Pathophysiology, Treatment, and Complications of Carcinoid Syndrome

“…Muscle wasting has been reported in small series as a result of malnutrition associated with uncontrolled diarrhoea [15]. Patients with carcinoid syndrome experience worse quality of life compared with patients with NEN without CS [30,31]. It is important note not all diarrhoea in patients with carcinoid syndrome is hormone related.…”

“…A survey of NEN patients in the USA (27% of total 186 patients with carcinoid tumours) showed 3.8% of patients fulfilled the criteria for depression and 18.3% of patients are at risk for depression based on the hospital anxiety and depression score (HADS) [94]. More recent studies screening patients with CS and without CS using HAD scores report 12% of patients with depression [30]. Other hormonally active substances released by the NEN which can pass the bloodbrain barrier could also contribute to cognitive problems [95].…”