Published October 14, 2023
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Gender-related differences in patients with carcinoid syndrome: new insights from an Italian multicenter cohort study.

Creators

  • 1. Endocrinology Unit, Department of Human Pathology of Adulthood and Childhood DETEV, University of Messina, 98125, Messina, Italy.
  • 2. Division of Endocrinology and Diabetes, Department of Internal Medicine, University of Würzburg, Würzburg, Germany.
  • 3. University of Würzburg
  • 4. SC Endocrinologia, Diabetologia e Malattie del Metabolismo, AO Ordine Mauriziano di Torino, Largo Turati, 62 10128, Turin, Italy.
  • 5. SCDU Oncologia, AO Ordine Mauriziano di Torino, Largo Turati, 62 10128, Turin, Italy.
  • 6. Department of Oncology, University Hospital San Luigi Gonzaga, University of Turin, Orbassano, Turin, Italy.
  • 7. University of Turin
  • 8. Internal Medicine, Department of Clinical and Biological Sciences, S. Luigi Hospital, University of Turin, Turin, Italy.
  • 9. Department of Biomedical Sciences, Humanitas University, 20089, Pieve Emanuele, Italy.
  • 10. Endocrinology, Diabetology and Andrology Unit, IRCCS Humanitas Research Hospital, 20089, Rozzano, Italy.
  • 11. Scientific Institute for Research, Hospitalization and Healthcare
  • 12. Pancreas Surgery Unit, IRCCS Humanitas Research Hospital, 20089, Rozzano, Italy.
  • 13. Medical Oncology and Hematology Unit, Humanitas Cancer Center, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy.
  • 14. Endocrinology Unit, Department of Internal Medicine and Medical Specialties (DIMI), University of Genova, 16132, Genoa, Italy.
  • 15. Endocrinology Unit, IRCCC Ospedale Policlinico San Martino, 16132, Genoa, Italy.
  • 16. Medical Oncology, Foundation IRCCS National Cancer Institute, Milan, Italy.
  • 17. First Department of Internal Medicine, San Matteo Hospital Foundation, Padua, Italy.
  • 18. Endocrinology, Diabetology and Andrology Unit, Department of Clinical Medicine and Surgery, Federico II University of Naples, Naples, Italy.
  • 19. Endocrine Unit, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy.
  • 20. Department of Medical and Surgical Sciences, University Magna Graecia of Catanzaro, Catanzaro, Italy.
  • 21. Endocrinology Unit, Department of Clinical and Molecular Medicine, Sant'Andrea Hospital, Sapienza University of Rome, ENETS Center of Excellence, Rome, Italy. virginia.zamponi@uniroma1.it.
  • 22. Sapienza University of Rome
  • 23. Section of Endocrinology, Geriatrics and Internal Medicine, Department of Medical Sciences, University of Ferrara, Ferrara, Italy.
  • 24. Endocrinology Unit, Department of Clinical and Molecular Medicine, Sant'Andrea Hospital, Sapienza University of Rome, ENETS Center of Excellence, Rome, Italy.
  • 25. Oncological Endocrinology Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy.
  • 26. Department of Medicine, Section of Endocrinology, University and Hospital Trust of Verona, Verona, Italy.
  • 27. Dipartimento di Promozione della Salute, Materno-Infantile, Medicina Interna e Specialistica di Eccellenza "G. D'Alessandro" (PROMISE), Sezione di Malattie Endocrine, del Ricambio e della Nutrizione, Università di Palermo, 90127, Palermo, Italy.
  • 28. Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy.
  • 29. Division of Medical Oncology 2, IRCCS Regina Elena National Cancer Institute, 00144, Rome, Italy.
  • 30. Neuroendocrine Tumour Unit, Department of Medicine, Surgery and Pharmacy, University of Sassari-Endocrine Unit, AOU Sassari, Sassari, Italy.
  • 31. Endocrinology Unit, Department of Clinical and Experimental Medicine, University of Catania and Garibaldi, Nesima Medical Center, Catania, Italy.
  • 32. UNESCO Chair on Health Education and Sustainable Development, Federico II University, 80138, Naples, Italy.

Description

The incidence of neuroendocrine neoplasm (NEN) and related carcinoid syndrome (CaS) has increased markedly in recent decades, and women appear to be more at risk than men. As per other tumors, gender may be relevant in influencing the clinical and prognostic characteristics of NEN-associated CS. However, specific data on carcinoid syndrome (CaS) are still lacking. To evaluate gender differences in clinical presentation and outcome of CaS. Retrospective analysis of 144 CaS patients from 20 Italian high-volume centers was conducted. Clinical presentation, tumor characteristics, therapies, and outcomes (progression-free survival, PFS, overall survival, OS) were correlated to gender. Ninety (62.5%) CaS patients were male. There was no gender difference in the site of primary tumor, tumor grade and clinical stage, as well as in treatments. Men were more frequently smokers (37.2%) and alcohol drinkers (17.8%) than women (9.5%, p = 0.002, and 3.7%, p = 0.004, respectively). Concerning clinical presentation, women showed higher median number of symptoms (p = 0.0007), more frequent abdominal pain, tachycardia, and psychiatric disorders than men (53.3% vs 70.4%, p = 0.044; 6.7% vs 31.5%, p = 0.001; 50.9% vs. 26.7%, p = 0.003, respectively). Lymph node metastases at diagnosis were more frequent in men than in women (80% vs 64.8%; p = 0.04), but no differences in terms of PFS (p = 0.51) and OS (p = 0.64) were found between gender. In this Italian cohort, CaS was slightly more frequent in males than females. Gender-related differences emerged in the clinical presentation of CaS, as well as gender-specific risk factors for CaS development. A gender-driven clinical management of these patients should be advisable. © 2023. The Author(s).
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