International practice patterns and resource utilization in the treatment of neuroendocrine tumors

Pancreas. 2013 Mar;42(2):339-47. doi: 10.1097/MPA.0b013e31826707cc.

Abstract

Objectives: This study compared resource use and practice patterns in patients with advanced neuroendocrine tumors (NETs) on disease progression, across countries, and by tumor type.

Methods: Physicians in the United States, United Kingdom, Germany, France, Brazil, and Italy completed data extraction forms to extract chart data of patients with NET relating to health care resource utilization and treatment practice. Data were assessed in a cross-sectional manner, by country, and by NET subtype. Univariate and multivariate analyses were performed to compare categories of resource use by disease progression status.

Results: A total of 197 physicians provided data on 394 patients. Overall resource utilization was high across tumor types, countries, and progression. Nearly half of all patients received chemotherapy (49%); moreover, high rates of hospitalization (65%), surgery (47%), and use of somatostatin analog (77%) were observed, with lower rates of peptide receptor radionuclide therapy (10%) and targeted therapies (6%). These patterns were consistent across gastrointestinal tract/lung NET and pancreatic NET. However, a certain variation in resource utilization was observed across countries. Disease progression was associated with increasing utilization of chemotherapy, hospitalization, and targeted therapy.

Conclusions: Advanced NET is associated with significant resource use across subtypes and countries, and resource utilization is likely to increase on disease progression. There remains an unmet need for therapeutic options after disease progression.

Publication types

  • Comparative Study
  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Brazil
  • Cross-Sectional Studies
  • Disease Progression
  • Europe
  • Health Care Surveys
  • Health Resources / statistics & numerical data*
  • Health Resources / trends*
  • Healthcare Disparities / trends
  • Humans
  • Internationality
  • Linear Models
  • Middle Aged
  • Multivariate Analysis
  • Neuroendocrine Tumors / pathology
  • Neuroendocrine Tumors / therapy*
  • Odds Ratio
  • Practice Patterns, Physicians' / trends*
  • Residence Characteristics
  • Time Factors
  • Treatment Outcome
  • United States
  • Young Adult