Endocrine Abstracts

Introduction: Neuroendocrine neoplasms (NEN) represent a group of rare neoplasms characterized by wide heterogeneity in terms of biological characteristics and clinical behavior. Despite their increasing relevance in the oncology field, health-related quality of life (HRQoL) and sexual function remain poorly investigated.

Aim: To investigate sexual function in patients affected by NEN; to evaluate the impact of clinical severity (presence or absence of metastases and tumor grade), heterogeneity (location of primary tumor and presence or absence of endocrine syndrome) and NEN therapies on sexual function and HRQoL; to study the possible correlation between these features and biochemical and psychological parameters.

Materials & Methods: In this cross-sectional, multicenter study, patients with a new diagnosis of gastroenteropancreatic (GEP) or bronchial NEN, aged 18 to 75 years, were recruited. Tumor severity, clinical heterogeneity, therapies performed were valuated. Through validated questionnaires, data about sexual function, sex-related distress, HRQoL, anxiety and depression were also collected. Furthermore, blood concentrations of LDL, glucose, HbA1c, and sex hormones were measured.

Results: To date, a total of 50 patients (28 men and 22 women) has been included. The mean age was 59.2 and 58.7 years, respectively. Of them, 71.6% were GEP, 33.4% bronchial; furthermore, 73.7% of patients were on systemic therapy, 35.0% had a metastatic form and 21.1% had an endocrine syndrome. The prevalence of erectile dysfunction (ED) was 60.7% (17/28) and the prevalence of female sexual dysfunctions (FSD) was 50.0% (11/22), without significant gender differences regarding the prevalence of dysfunctions and sex-related distress (P= 0.5). Furthermore, only 17.9% (5/28) of men were satisfied with their sexual life, compared to 31.8% of women (7/22; P=0.32). A different impact of tumor severity on men and women was found; while tumor grading mainly influenced sexual function in men (P= 0.001), the presence of metastases would seem to be the most impacting factor on sexual function in women (P= 0.023). Higher levels of sexual distress reported higher glucose levels and greater perceived psychological distress, as well as a lower HRQoL (P = 0.039, r= 0.45). Furthermore, only female sexual function was related with LDL values (P=0.03, r=0.8).

Conclusion: These results highlighted the relationship between NEN clinical severity, sexual dysfunction, and sex-related distress, suggesting that more attention should be paid to sexual function and distress in the clinical management of NEN patients, including female population, to promote better QoL and minimize psychological distress.