Patients with neuroendocrine neoplasms referred to the palliative care teams of tertiary care centers: a multicenter retrospective descriptive study

Abstract

Neuroendocrine neoplasms (NENs) can be divided into well-differentiated neuroendocrine tumors and poorly differentiated carcinomas (NETs and NECs, respectively). Although the incidence of NENs is increasing globally, reports on palliative care in affected populations are scarce. This study aimed to describe the state of palliative care team (PCT) interventions for patients with NENs referred to tertiary care centers’ PCTs. Among the patients with neoplasms referred to tertiary care centers’ PCTs during January 2017–June 2025, those histopathologically diagnosed with NENs were included. They were classified as having NETs or NECs, and baseline characteristics, reason for PCT referral, and outcomes after PCT intervention were investigated. Additionally, for patients referred to a PCT because of pain, the numerical rating scale (NRS) score, cause of pain, pain type, pain management details, and the equivalent oral morphine dose (EOMD) were also investigated. These parameters were compared between patients with NETs and NECs. Among 3,190 patients with neoplasms referred to tertiary care centers’ PCTs, 48 (1.5%) had NENs, including 32 with NETs and 16 with NECs. Pain was the most common reason for PCT consultation (39/48 patients). Patients with NECs had significantly higher NRS scores and EOMD at consultation and a significantly higher mortality. Non-neoplastic pain was also identified in 5 patients (12.8%), for whom PCT-led opioid tapering and discontinuation were promoted to ensure appropriate opioid use. Given the diverse clinical course of NENs, research on palliative care and pain control for affected patients must be further deepened.