ArticleSupportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer2026
Symptom burden and outcomes among patients with early-onset versus average-onset neuroendocrine neoplasms.
Article in Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundThe incidence of neuroendocrine neoplasms (NENs) is rising, particularly among younger patients, but data comparing early-onset (EO-NENs) and average-onset (AO-NENs) remain limited. Using the National Inpatient Sample (2016-2020), we compared patient characteristics, symptom burden, and outcomes between these groups.
methodsHospitalizations with NENs were identified using ICD-10 codes and stratified as EO (< 50 years) or AO (≥ 50 years). Demographics, comorbidities, symptom burden, interventions, and outcomes were compared using t-tests, chi-squared tests, and logistic regression analysis (p < 0.001 significant because of Bonferroni correction).
resultsWe identified 22,555 EO-NEN and 149,470 AO-NEN hospitalizations. EO-NEN patients were more often female (55% vs. 49%). Private insurance was more common in EO-NENs (59% vs. 28%, p < 0.001). EO-NENs were more frequently intestinal or thymic in origin. Symptom burden was higher in EO-NENs, including nausea/vomiting (8.6% vs. 4.7%), constipation (13.9% vs. 10.8%), abdominal pain (1.9% vs. 1.3%), and anxiety (18.3% vs. 14.0%; all p < 0.001). AO-NENs experienced more acute complications (heart failure, cardiac arrest). Multivariate analysis showed no significant difference in odds of inpatient mortality between both cohorts. EO-NEN hospitalizations had higher rates of treatment with chemotherapy (6.1% vs. 4.2%) and surgical resection.
conclusionsEO-NENs represent a clinically distinct subset with greater symptom burden but fewer acute complications and similar mortality compared to AO-NENs. These findings highlight the need for age-tailored care pathways and further research into the unique biology driving EO-NENs.
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