Prevalence of co-morbidities in elderly patients with distant stage neuroendocrine tumors.

Abstract

e15699 Background: The median age of diagnosis of neuroendocrine tumors (NETs), an indolent tumor characterized by hormone production (carcinoid syndrome, CS) when metastatic is 63 years. Patients (pts) in this age group have multiple co-morbidities. However, their prevalence among elderly pts with metastatic NET is unknown. Methods: The Surveillance, Epidemiology and End Results (SEER)-Medicare database was used to identify 2,388 elderly patients with distant stage NET (Age: < 70: 631; 70-79: 1200; > 80: 557; Race: white: 83.4%, black: 8.6%) diagnosed between 1/03 and 12/11 identified by ICD-O-3 codes with continuous Medicare Parts A and B enrollment during the one year after NET diagnosis. We examined the prevalence of common co-morbidities in the elderly population: dementia, heart conditions including ischemic heart disease (IHD), hypertension (HTN) & congestive heart failure, chronic obstructive pulmonary disease, chronic kidney disease, hyperlipidemia, diabetes, arthritis, and two additional relevant comorbidities: osteoporosis (OP) and non-rheumatic tricuspid valve (TV) disorders. Pts were considered to have a condition if they had ≥ 1 inpt or ≥ 2 outpt visits indicative of the condition. We compared the prevalence in the NET group with that in a propensity score matched non-cancer group using chi-square test. Within the NET group, we also examined the association between pt characteristics and the presence of the conditions using a logistic regression model. Results: Compared to the matched non-cancer control group, NET pts were significantly (P < 0.01) more likely to have HTN (74% vs. 66%), OP (14% vs. 11%) & TV disorders (1.72% vs. 0.98%) and less likely to have dementia (7.3% vs 17.4%), IHD (23.2% vs 29%) and diabetes (30.3% vs 33.5%). CS was noted in 25.7% of the NET group and logistic regression showed that these pts with were significantly more likely to have TV disorders (AOR = 2.52, 95% CI: 1.24-5.14) and osteoporosis (AOR: 1.34, 95% CI: 1.01-1.81). Conclusions: This population-based study showed that elderly NET pts have significantly different prevalence of co-morbidities compared to non-cancer controls. The impact of these conditions on survival and therapeutic decisions is being evaluated.