背景:近几十年来,神经内分泌肿瘤(NEN)和相关类癌综合征(CaS)的发病率明显增加,女性似乎比男性更有风险。至于其他肿瘤,性别可能与影响NEN相关CS的临床和预后特征有关.然而,关于类癌综合征(CaS)的具体数据仍然缺乏。
目的:评估CaS临床表现和结局的性别差异。
方法:回顾性分析来自20个意大利高容量中心的144例CaS患者。临床表现,肿瘤特征,疗法,和结果(无进展生存期,PFS,总生存率,OS)与性别相关。
结果:90例(62.5%)CaS患者为男性。原发肿瘤部位无性别差异,肿瘤分级和临床分期,以及在治疗中。男性吸烟者(37.2%)和饮酒者(17.8%)比女性(9.5%,p=0.002,和3.7%,分别为p=0.004)。关于临床表现,女性表现出更高的症状中位数(p=0.0007),更频繁的腹痛,心动过速,精神疾病高于男性(53.3%vs70.4%,p=0.044;6.7%对31.5%,p=0.001;50.9%vs.26.7%,分别为p=0.003)。诊断时淋巴结转移男性比女性更频繁(80%vs64.8%;p=0.04),但性别间PFS(p=0.51)和OS(p=0.64)无差异。
结论:在这个意大利队列中,男性的CaS频率略高于女性。在CaS的临床表现中出现了与性别相关的差异,以及CaS发展的性别特异性风险因素。应建议对这些患者进行性别驱动的临床管理。
BACKGROUND: 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.
OBJECTIVE: To evaluate gender differences in clinical presentation and outcome of CaS.
METHODS: 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.
RESULTS: 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.
CONCLUSIONS: 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.