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 and 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, populat...

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Main Authors: Marie Line El Asmar, Mohamed Mortagy, Benjamin E White, Dan Burns, John Ramage
Format: Article
Language:English
Published: Bioscientifica 2025-04-01
Series:Endocrine Oncology
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Online Access:https://eo.bioscientifica.com/view/journals/eo/5/1/EO-25-0012.xml
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author Marie Line El Asmar
Mohamed Mortagy
Benjamin E White
Dan Burns
John Ramage
author_facet Marie Line El Asmar
Mohamed Mortagy
Benjamin E White
Dan Burns
John Ramage
author_sort Marie Line El Asmar
collection DOAJ
description Objective: The time from onset of symptoms of neuroendocrine neoplasia (NEN) to diagnosis ranges between 5 and 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 that 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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spelling doaj-art-b70c3f4300c444e69a14c7f95f92a3df2025-08-20T03:13:50ZengBioscientificaEndocrine Oncology2634-47932025-04-015110.1530/EO-25-00121Emergency and routine presentation of neuroendocrine neoplasia in England: determinants of late presentation and survival outcomesMarie Line El Asmar0Mohamed Mortagy1Benjamin E White2Dan Burns3John Ramage4Department of Gastroenterology, Hampshire Hospitals NHS Foundation Trust, Basingstoke, UKHampshire Hospitals NHS Foundation Trust, Winchester, UKDepartment of Gastroenterology, Hampshire Hospitals NHS Foundation Trust, Basingstoke, UKHampshire Hospitals NHS Foundation Trust, Winchester, UKDepartment of Gastroenterology, Hampshire Hospitals NHS Foundation Trust, Basingstoke, UKObjective: The time from onset of symptoms of neuroendocrine neoplasia (NEN) to diagnosis ranges between 5 and 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 that 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.https://eo.bioscientifica.com/view/journals/eo/5/1/EO-25-0012.xmlneuroendocrine neoplasiapresentationdiagnosisneuroendocrine tumourneuroendocrine tumourneuroendocrine carcinomanetnecsurvivalmachine learningxgboost
spellingShingle Marie Line El Asmar
Mohamed Mortagy
Benjamin E White
Dan Burns
John Ramage
Emergency and routine presentation of neuroendocrine neoplasia in England: determinants of late presentation and survival outcomes
Endocrine Oncology
neuroendocrine neoplasia
presentation
diagnosis
neuroendocrine tumour
neuroendocrine tumour
neuroendocrine carcinoma
net
nec
survival
machine learning
xgboost
title Emergency and routine presentation of neuroendocrine neoplasia in England: determinants of late presentation and survival outcomes
title_full Emergency and routine presentation of neuroendocrine neoplasia in England: determinants of late presentation and survival outcomes
title_fullStr Emergency and routine presentation of neuroendocrine neoplasia in England: determinants of late presentation and survival outcomes
title_full_unstemmed Emergency and routine presentation of neuroendocrine neoplasia in England: determinants of late presentation and survival outcomes
title_short Emergency and routine presentation of neuroendocrine neoplasia in England: determinants of late presentation and survival outcomes
title_sort emergency and routine presentation of neuroendocrine neoplasia in england determinants of late presentation and survival outcomes
topic neuroendocrine neoplasia
presentation
diagnosis
neuroendocrine tumour
neuroendocrine tumour
neuroendocrine carcinoma
net
nec
survival
machine learning
xgboost
url https://eo.bioscientifica.com/view/journals/eo/5/1/EO-25-0012.xml
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