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Emergency and routine presentation of neuroendocrine neoplasia in England: determinants of late presentation and survival outcomes

Emergency and routine presentation of neuroendocrine neoplasia in England: determinants of late presentation and survival outcomes
Emergency and routine presentation of neuroendocrine neoplasia in England: determinants of late presentation and survival outcomes
Objective: the time from onset of symptoms of neuroendocrine neoplasia (NEN) to diagnosis ranges between 5-7 years. Risk factors associated with this and the difference in overall survival (OS) between routine and emergency presentation (RP and EP) are not known.

Design: a retrospective, population-based study.

Methods: a retrospective, population-based study of gastroenteropancreatic and lung NEN registered on England’s national cancer between 2012 and 2021. Factors associated with worse OS, or emergency or late presentation (EP or LP), were evaluated using the Kaplan–Meier estimator, Cox and logistic regressions, and machine learning (ML) in two models.

Results: a total of 21,345 NEN were included. 20.3% were EP. EP showed worse OS compared to RP. Factors associated with EP were male sex, advanced stage, worse deprivation, and NEC. The ML model showed EP related to advanced stage, small intestinal NEN, NEC, advanced age, deprivation, and male sex in decreasing order of importance. Factors associated with LP included
EP, male sex, and NEC. The ML model showed NEC, small intestinal NEN, advanced age, EP, and male sex are associated with LP in decreasing order of importance.

Conclusion: EP is associated with poor survival. Addressing the associated factors may aid in timely diagnosis and improved survival
2634-4793
e250012
El Asmar, Marie Line
dc4aa74b-ce9b-4071-a031-2bbe38556225
Mortagy, Mohamed
b287fe0d-db21-4917-a5f5-1e6df612bef4
White, Benjamin E.
c7bf3f6c-96a4-4c11-9639-ccc4ad5d7041
Burns, Dan
40b9dc88-a54a-4365-b747-4456d9203146
Ramage, John
42cd799f-c5fc-4493-b4bd-3209d0f7139f
El Asmar, Marie Line
dc4aa74b-ce9b-4071-a031-2bbe38556225
Mortagy, Mohamed
b287fe0d-db21-4917-a5f5-1e6df612bef4
White, Benjamin E.
c7bf3f6c-96a4-4c11-9639-ccc4ad5d7041
Burns, Dan
40b9dc88-a54a-4365-b747-4456d9203146
Ramage, John
42cd799f-c5fc-4493-b4bd-3209d0f7139f

El Asmar, Marie Line, Mortagy, Mohamed, White, Benjamin E., Burns, Dan and Ramage, John (2025) Emergency and routine presentation of neuroendocrine neoplasia in England: determinants of late presentation and survival outcomes. Endocrine Oncology, 5 (1), e250012. (doi:10.1530/EO-25-0012).

Record type: Article

Abstract

Objective: the time from onset of symptoms of neuroendocrine neoplasia (NEN) to diagnosis ranges between 5-7 years. Risk factors associated with this and the difference in overall survival (OS) between routine and emergency presentation (RP and EP) are not known.

Design: a retrospective, population-based study.

Methods: a retrospective, population-based study of gastroenteropancreatic and lung NEN registered on England’s national cancer between 2012 and 2021. Factors associated with worse OS, or emergency or late presentation (EP or LP), were evaluated using the Kaplan–Meier estimator, Cox and logistic regressions, and machine learning (ML) in two models.

Results: a total of 21,345 NEN were included. 20.3% were EP. EP showed worse OS compared to RP. Factors associated with EP were male sex, advanced stage, worse deprivation, and NEC. The ML model showed EP related to advanced stage, small intestinal NEN, NEC, advanced age, deprivation, and male sex in decreasing order of importance. Factors associated with LP included
EP, male sex, and NEC. The ML model showed NEC, small intestinal NEN, advanced age, EP, and male sex are associated with LP in decreasing order of importance.

Conclusion: EP is associated with poor survival. Addressing the associated factors may aid in timely diagnosis and improved survival

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e-pub ahead of print date: 14 April 2025
Published date: 14 April 2025

Identifiers

Local EPrints ID: 500902
URI: http://eprints.soton.ac.uk/id/eprint/500902
ISSN: 2634-4793
PURE UUID: f64459aa-ebda-4c86-a6ad-cb1803b1d1f0
ORCID for Dan Burns: ORCID iD orcid.org/0000-0001-6976-1068

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Date deposited: 15 May 2025 16:58
Last modified: 30 Aug 2025 01:55

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Contributors

Author: Marie Line El Asmar
Author: Mohamed Mortagy
Author: Benjamin E. White
Author: Dan Burns ORCID iD
Author: John Ramage

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