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Erschienen in: World Journal of Surgery 10/2018

01.05.2018 | Original Scientific Report

Health-Related Quality of Life After Surgery for Small Intestinal Neuroendocrine Tumours

verfasst von: Anna Caterina Milanetto, Erik Nordenström, Anna Sundlöv, Martin Almquist

Erschienen in: World Journal of Surgery | Ausgabe 10/2018

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Abstract

Background

Overall survival for patients with small intestinal neuroendocrine tumours (siNETs) is long, even with metastatic disease, making quality of life issues relevant. The impact of surgery on quality of life is not known. We investigated determinants of health-related quality of life in patients who had undergone surgery for a siNET.

Methods

Patients operated for a siNET between 1998 and 2016 at Skåne University Hospital (Lund, Sweden), who were alive in February 2017, were sent two questionnaires constructed by the European Organisation for Research and Treatment of Cancer (EORTC QLQ-C30, EORTC QLQ-GINET21). Global quality of life, physical function, disease-related worries, diarrhoea and endocrine symptoms were evaluated with linear and logistic regression in relation to patient-, tumour- and treatment-related factors. Statistical analysis was performed using STATA 11®.

Results

One hundred patients (84%) completed the questionnaires. Women had worse global quality of life (p = 0.019), more disease-related worries (p < 0.001) and endocrine symptoms (p = 0.017) than men. Older age was associated with more disease-related worries (p = 0.007), but fewer endocrine symptoms (p = 0.034). Non-symptomatic tumour versus symptomatic tumour (p = 0.002), and treatment with somatostatin analogues versus no treatment (p = 0.040) were associated with less diarrhoea. Small versus large bowel resection was associated with better global quality of life (p = 0.036) and physical function (p = 0.035).

Conclusions

Male gender, younger age, treatment with somatostatin analogues, non-symptomatic tumour, and small intestinal surgery rather than large bowel surgery were associated with better quality of life.
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Literatur
1.
Zurück zum Zitat Frilling A, Akerström G, Falconi M et al (2012) Neuroendocrine tumor disease: an evolving landscape. Endocr Relat Cancer 19:R163–R185CrossRefPubMed Frilling A, Akerström G, Falconi M et al (2012) Neuroendocrine tumor disease: an evolving landscape. Endocr Relat Cancer 19:R163–R185CrossRefPubMed
2.
Zurück zum Zitat Pape UF, Berndt U, Müller-Nordhorn J et al (2008) Prognostic factors of long-term outcome in gastroenteropancreatic neuroendocrine tumours. Endocr Relat Cancer 15(4):1083–1097CrossRefPubMed Pape UF, Berndt U, Müller-Nordhorn J et al (2008) Prognostic factors of long-term outcome in gastroenteropancreatic neuroendocrine tumours. Endocr Relat Cancer 15(4):1083–1097CrossRefPubMed
3.
Zurück zum Zitat Ahmed A, Turner G, King B et al (2009) Midgut neuroendocrine tumours with liver metastases: results of the UKINETS study. Endocr Relat Cancer 16(3):885–894CrossRefPubMed Ahmed A, Turner G, King B et al (2009) Midgut neuroendocrine tumours with liver metastases: results of the UKINETS study. Endocr Relat Cancer 16(3):885–894CrossRefPubMed
4.
Zurück zum Zitat Chambers AJ, Pasieka JL, Dixon E et al (2008) The palliative benefit of aggressive surgical intervention for both hepatic and mesenteric metastases from neuroendocrine tumors. Surgery 144(4):645–651CrossRefPubMed Chambers AJ, Pasieka JL, Dixon E et al (2008) The palliative benefit of aggressive surgical intervention for both hepatic and mesenteric metastases from neuroendocrine tumors. Surgery 144(4):645–651CrossRefPubMed
5.
Zurück zum Zitat Rinke A, Müller HH, Schade-Brittinger C et al (2009) Placebo-controlled, double-blind, prospective, randomized study on the effect of octreotide LAR in the control of tumor growth in patients with metastatic neuroendocrine midgut tumors: a report from the PROMID Study Group. J Clin Oncol 27(28):4656–4663CrossRefPubMed Rinke A, Müller HH, Schade-Brittinger C et al (2009) Placebo-controlled, double-blind, prospective, randomized study on the effect of octreotide LAR in the control of tumor growth in patients with metastatic neuroendocrine midgut tumors: a report from the PROMID Study Group. J Clin Oncol 27(28):4656–4663CrossRefPubMed
6.
Zurück zum Zitat Caplin ME, Pavel M, Ćwikła JB et al (2014) Lanreotide in metastatic enteropancreatic neuroendocrine tumors. N Engl J Med 371(3):224–233CrossRefPubMed Caplin ME, Pavel M, Ćwikła JB et al (2014) Lanreotide in metastatic enteropancreatic neuroendocrine tumors. N Engl J Med 371(3):224–233CrossRefPubMed
7.
Zurück zum Zitat Kwekkeboom DJ, de Herder WW, Kam BL et al (2008) Treatment with the radiolabeled somatostatin analog [177 Lu-DOTA 0, Tyr3] octreotate: toxicity, efficacy, and survival. J Clin Oncol 26(13):2124–2130CrossRefPubMed Kwekkeboom DJ, de Herder WW, Kam BL et al (2008) Treatment with the radiolabeled somatostatin analog [177 Lu-DOTA 0, Tyr3] octreotate: toxicity, efficacy, and survival. J Clin Oncol 26(13):2124–2130CrossRefPubMed
8.
Zurück zum Zitat Paganelli G, Sansovini M, Ambrosetti A et al (2014) 177 Lu-Dota-octreotate radionuclide therapy of advanced gastrointestinal neuroendocrine tumors: results from a phase II study. Eur J Nucl Med Mol Imaging 41(10):1845–1851CrossRefPubMed Paganelli G, Sansovini M, Ambrosetti A et al (2014) 177 Lu-Dota-octreotate radionuclide therapy of advanced gastrointestinal neuroendocrine tumors: results from a phase II study. Eur J Nucl Med Mol Imaging 41(10):1845–1851CrossRefPubMed
9.
Zurück zum Zitat Cella DF (1995) Measuring quality of life in palliative care. Semin Oncol 22:73–81PubMed Cella DF (1995) Measuring quality of life in palliative care. Semin Oncol 22:73–81PubMed
10.
Zurück zum Zitat Davies AHG, Larsson G, Ardill J et al (2006) Development of a disease-specific quality of life questionnaire module for patients with gastrointestinal neuroendocrine tumours. Eur J Cancer 42(4):477–484CrossRefPubMed Davies AHG, Larsson G, Ardill J et al (2006) Development of a disease-specific quality of life questionnaire module for patients with gastrointestinal neuroendocrine tumours. Eur J Cancer 42(4):477–484CrossRefPubMed
11.
Zurück zum Zitat Beaumont JL, Cella D, Phan AT et al (2012) Comparison of health-related quality of life in patients with neuroendocrine tumors with quality of life in the general US population. Pancreas 41(3):461–466CrossRefPubMed Beaumont JL, Cella D, Phan AT et al (2012) Comparison of health-related quality of life in patients with neuroendocrine tumors with quality of life in the general US population. Pancreas 41(3):461–466CrossRefPubMed
12.
Zurück zum Zitat Larsson G, von Essen L, Sjödén PO (1999) Health-related quality of life in patients with endocrine tumours of the gastrointestinal tract. Acta Oncol 38(4):481–490CrossRefPubMed Larsson G, von Essen L, Sjödén PO (1999) Health-related quality of life in patients with endocrine tumours of the gastrointestinal tract. Acta Oncol 38(4):481–490CrossRefPubMed
13.
Zurück zum Zitat Teunissen JJ, Kwekkeboom DJ, Krenning EP (2004) Quality of life in patients with gastroenteropancreatic tumors treated with [177Lu-DOTA0, Tyr3]octreotate. J Clin Oncol 22(13):2724–2729CrossRefPubMed Teunissen JJ, Kwekkeboom DJ, Krenning EP (2004) Quality of life in patients with gastroenteropancreatic tumors treated with [177Lu-DOTA0, Tyr3]octreotate. J Clin Oncol 22(13):2724–2729CrossRefPubMed
14.
Zurück zum Zitat Pavel M, Unger N, Borbath I et al (2016) Safety and QOL in patients with advanced NET in a phase 3b expanded access study of everolimus. Target Oncol 11(5):667–675CrossRefPubMed Pavel M, Unger N, Borbath I et al (2016) Safety and QOL in patients with advanced NET in a phase 3b expanded access study of everolimus. Target Oncol 11(5):667–675CrossRefPubMed
15.
Zurück zum Zitat Aaronson NK, Ahmedzai S, Bergman B et al (1993) The European organization for research and treatment of cancer QLQ-C30: a quality-of-life instrument for use in international clinical trials in oncology. J Natl Cancer Inst 85:365–376CrossRefPubMed Aaronson NK, Ahmedzai S, Bergman B et al (1993) The European organization for research and treatment of cancer QLQ-C30: a quality-of-life instrument for use in international clinical trials in oncology. J Natl Cancer Inst 85:365–376CrossRefPubMed
16.
Zurück zum Zitat Yadegarfar G, Friend L, Jones L et al (2013) Validation of the EORTC QLQ-GINET21 questionnaire for assessing quality of life of patients with gastrointestinal neuroendocrine tumors. BJC 108:301–310CrossRefPubMedPubMedCentral Yadegarfar G, Friend L, Jones L et al (2013) Validation of the EORTC QLQ-GINET21 questionnaire for assessing quality of life of patients with gastrointestinal neuroendocrine tumors. BJC 108:301–310CrossRefPubMedPubMedCentral
17.
Zurück zum Zitat Fayers PM, Aaronson NK, Bjordal K et al (2001) Scoring procedures. In: The EORTC QLQ-C30 scoring manual 3rd edn. EORTC Quality of Life Group, Brussels, pp 6–14 Fayers PM, Aaronson NK, Bjordal K et al (2001) Scoring procedures. In: The EORTC QLQ-C30 scoring manual 3rd edn. EORTC Quality of Life Group, Brussels, pp 6–14
18.
Zurück zum Zitat Fröjd C, Larsson G, Lampic C et al (2007) Health related quality of life and psychosocial function among patients with carcinoid tumours. A longitudinal, prospective, and comparative study. Health Qual Life Outcomes 11(5):18CrossRef Fröjd C, Larsson G, Lampic C et al (2007) Health related quality of life and psychosocial function among patients with carcinoid tumours. A longitudinal, prospective, and comparative study. Health Qual Life Outcomes 11(5):18CrossRef
19.
Zurück zum Zitat Scott NW, Fayers PM, Aaronson NK et al (2008) EORTC QLQ-C30 tables of reference values. In: The EORTC QLQ-C30 reference values manual. EORTC Quality of Life Group Publications, Brussels, pp 14–294 Scott NW, Fayers PM, Aaronson NK et al (2008) EORTC QLQ-C30 tables of reference values. In: The EORTC QLQ-C30 reference values manual. EORTC Quality of Life Group Publications, Brussels, pp 14–294
20.
Zurück zum Zitat Hjermstad MJ, Fayers PM, Bjordal K et al (1998) Health-related quality of life in the general Norwegian population assessed by the European Organization for Research and Treatment of Cancer Core Quality-of-Life Questionnaire: the QLQ = C30 (+ 3). J Clin Oncol 16(3):1188–1196CrossRefPubMed Hjermstad MJ, Fayers PM, Bjordal K et al (1998) Health-related quality of life in the general Norwegian population assessed by the European Organization for Research and Treatment of Cancer Core Quality-of-Life Questionnaire: the QLQ = C30 (+ 3). J Clin Oncol 16(3):1188–1196CrossRefPubMed
21.
Zurück zum Zitat Derogar M, van der Schaaf M, Lagergren P (2012) Reference values for the EORTC QLQ-C30 quality of life questionnaire in a random sample of the Swedish population. Acta Oncol 51(1):10–16CrossRefPubMed Derogar M, van der Schaaf M, Lagergren P (2012) Reference values for the EORTC QLQ-C30 quality of life questionnaire in a random sample of the Swedish population. Acta Oncol 51(1):10–16CrossRefPubMed
22.
Zurück zum Zitat Michelson H, Bolund C, Nilsson B et al (2000) Health-related quality of life measured by the EORTC QLQ-C30: reference values from a large sample of Swedish population. Acta Oncol 39(4):477–484CrossRefPubMed Michelson H, Bolund C, Nilsson B et al (2000) Health-related quality of life measured by the EORTC QLQ-C30: reference values from a large sample of Swedish population. Acta Oncol 39(4):477–484CrossRefPubMed
23.
Zurück zum Zitat Schwarz R, Hinz A (2001) Reference data for the quality of life questionnaire EORTC QLQ-C30in the general German population. Eur J Cancer 37:1345–1351CrossRefPubMed Schwarz R, Hinz A (2001) Reference data for the quality of life questionnaire EORTC QLQ-C30in the general German population. Eur J Cancer 37:1345–1351CrossRefPubMed
24.
Zurück zum Zitat Djärv T, Wikman A, Johar A et al (2013) Poor health-related quality of life in the Swedish general population: the association with disease and lifestyle factors. Scand J Public Health 41(7):744–753CrossRefPubMed Djärv T, Wikman A, Johar A et al (2013) Poor health-related quality of life in the Swedish general population: the association with disease and lifestyle factors. Scand J Public Health 41(7):744–753CrossRefPubMed
25.
Zurück zum Zitat Larsson G, Sjödén PO, Oberg K et al (2001) Health-related quality of life, anxiety and depression in patients with midgut carcinoid tumours. Acta Oncol 40(7):825–831CrossRefPubMed Larsson G, Sjödén PO, Oberg K et al (2001) Health-related quality of life, anxiety and depression in patients with midgut carcinoid tumours. Acta Oncol 40(7):825–831CrossRefPubMed
26.
Zurück zum Zitat Akerström G, Hellman P, Hessman O (2005) Midgut carcinoid tumours: surgical treatment and prognosis. Best Pract Res Clin Gastroenterol 19:717–728CrossRef Akerström G, Hellman P, Hessman O (2005) Midgut carcinoid tumours: surgical treatment and prognosis. Best Pract Res Clin Gastroenterol 19:717–728CrossRef
27.
Zurück zum Zitat Eriksson B, Klöppel G, Krenning E et al (2008) Consensus guidelines for the management of patients with digestive neuroendocrine tumors well-differentiated jejunal-ileal tumor/carcinoma. Neuroendocrinology 87:8–19CrossRefPubMed Eriksson B, Klöppel G, Krenning E et al (2008) Consensus guidelines for the management of patients with digestive neuroendocrine tumors well-differentiated jejunal-ileal tumor/carcinoma. Neuroendocrinology 87:8–19CrossRefPubMed
28.
Zurück zum Zitat Daskalakis K, Karakatsanis A, Hessman O et al (2018) Association of a prophylactic surgical approach to stage IV small intestinal neuroendocrine tumors with survival. JAMA Oncol 4(2):183–189CrossRefPubMed Daskalakis K, Karakatsanis A, Hessman O et al (2018) Association of a prophylactic surgical approach to stage IV small intestinal neuroendocrine tumors with survival. JAMA Oncol 4(2):183–189CrossRefPubMed
Metadaten
Titel
Health-Related Quality of Life After Surgery for Small Intestinal Neuroendocrine Tumours
verfasst von
Anna Caterina Milanetto
Erik Nordenström
Anna Sundlöv
Martin Almquist
Publikationsdatum
01.05.2018
Verlag
Springer International Publishing
Erschienen in
World Journal of Surgery / Ausgabe 10/2018
Print ISSN: 0364-2313
Elektronische ISSN: 1432-2323
DOI
https://doi.org/10.1007/s00268-018-4638-2

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