Annie Lemelin1, Delphine Maucort-Boulch2,3, Elisabeth Castel-Kremer4, Julien Forestier1, Valérie Hervieu5,3, Marianne Lorcet1, Florent Boutitie2, Aurélie Theillaumas1, Philip Robinson6, Antoine Duclos7,3, Catherine Lombard-Bohas1, Thomas Walter8,9. 1. Service de Gastroentérologie et d'Oncologie Médicale, Hospices Civils de Lyon, Hôpital Edouard Herriot, Lyon, France. 2. Service de Biostatistique, Laboratoire de Biométrie et Biologie Evolutive, Equipe Biostatistique-Santé, Hospices Civils de Lyon, Université Lyon 1, Lyon, France. 3. Lyon 1 Claude Bernard University, Lyon, France. 4. Service de Médecine Gériatrique, Hospices Civils de Lyon, Hôpital Edouard Herriot, Lyon, France. 5. Service Central d'Anatomie et Cytologie Pathologiques, Hospices Civils de Lyon, Hôpital Edouard Herriot, Lyon, France. 6. DRCI, Hospices Civils de Lyon, Lyon, France. 7. Service des Données de Santé, Hospices Civils de Lyon, Health Services and Performance Research lab (HESPER EA 7425), Lyon, France. 8. Service de Gastroentérologie et d'Oncologie Médicale, Hospices Civils de Lyon, Hôpital Edouard Herriot, Lyon, France, thomas.walter@chu-lyon.fr. 9. Lyon 1 Claude Bernard University, Lyon, France, thomas.walter@chu-lyon.fr.
Abstract
INTRODUCTION: The incidence of neuroendocrine tumors (NETs) is rising, especially in elderly patients. The elderly cancer population presents considerable challenges, yet little is known about the characteristics, treatment patterns, and outcomes of metastatic NET (mNET) patients. METHODS: The Lyon Real-life Evidence in Metastatic NeuroEndocrine Tumors study (LyREMeNET, NCT03863106) included consecutive mNET patients, diagnosed between January 1990 and December 2017. The exclusion criteria were nonmetastatic NET, poorly differentiated neuroendocrine carcinoma, and mixed neuroendocrine-nonneuroendocrine neoplasms. We aimed to compare patients ≥70 years old to patients <70 years old. RESULTS: A total of 866 patients were included, 198 (23%) were ≥70 years old. There was no significant difference in characteristics except that elderly patients had synchronous metastasis more frequently. Elderly patients received significantly fewer treatments (median of 2.0 vs. 3.0 lines, respectively, p < 0.0001), were significantly less frequently treated by chemotherapy (32 vs. 54%), targeted therapy (16 vs. 30%), peptide receptor radionuclide therapy (5 vs. 16%), and they underwent significantly less frequently locoregional intervention. Median overall survival was significantly shorter in elderly patients (5.2 vs. 9.6 years). The most frequent cause of death was related to disease progression (71%). Multivariate analysis found that, after adjustment for tumor location, tumor grade, and number of metastatic sites, age remained significantly associated with overall survival (HR 1.66, 95% CI 1.26-2.18), indicating a poorer survival in patients ≥70 years old in comparison with younger patients (p = 0.0003). CONCLUSION: Patients ≥70 years old have a worse survival, die frequently from their disease, and are undertreated compared to younger patients.
INTRODUCTION: The incidence of neuroendocrine tumors (NETs) is rising, especially in elderly patients. The elderly cancer population presents considerable challenges, yet little is known about the characteristics, treatment patterns, and outcomes of metastatic NET (mNET) patients. METHODS: The Lyon Real-life Evidence in Metastatic NeuroEndocrine Tumors study (LyREMeNET, NCT03863106) included consecutive mNET patients, diagnosed between January 1990 and December 2017. The exclusion criteria were nonmetastatic NET, poorly differentiated neuroendocrine carcinoma, and mixed neuroendocrine-nonneuroendocrine neoplasms. We aimed to compare patients ≥70 years old to patients <70 years old. RESULTS: A total of 866 patients were included, 198 (23%) were ≥70 years old. There was no significant difference in characteristics except that elderly patients had synchronous metastasis more frequently. Elderly patients received significantly fewer treatments (median of 2.0 vs. 3.0 lines, respectively, p < 0.0001), were significantly less frequently treated by chemotherapy (32 vs. 54%), targeted therapy (16 vs. 30%), peptide receptor radionuclide therapy (5 vs. 16%), and they underwent significantly less frequently locoregional intervention. Median overall survival was significantly shorter in elderly patients (5.2 vs. 9.6 years). The most frequent cause of death was related to disease progression (71%). Multivariate analysis found that, after adjustment for tumor location, tumor grade, and number of metastatic sites, age remained significantly associated with overall survival (HR 1.66, 95% CI 1.26-2.18), indicating a poorer survival in patients ≥70 years old in comparison with younger patients (p = 0.0003). CONCLUSION:Patients ≥70 years old have a worse survival, die frequently from their disease, and are undertreated compared to younger patients.
Authors: Karin Mayer; Selina Kiry; Anna Yordanova; Hojjat Ahmadzadehfar; Florian C Gaertner; Ralph A Bundschuh; Markus Essler; Maria A Gonzalez-Carmona; Christian P Strassburg; Hanno Matthaei; Philipp Lingohr; Savita Bisht; Peter Brossart; Georg Feldmann Journal: Int J Endocrinol Date: 2020-01-31 Impact factor: 3.257
Authors: Deborah Theiler; Marco Cattaneo; Lawrence O Dierickx; Peter Igaz; Simona Grozinsky-Glasberg; Claire Bournaud; Thomas O'Dorisio; M Sue O'Dorisio; Damian Wild; Emanuel Christ; Guillaume P Nicolas Journal: Cancers (Basel) Date: 2021-12-15 Impact factor: 6.639