The Journal of Clinical Endocrinology & Metabolism, 2021, Vol. 106, No. 1, e316–e327 doi:10.1210/clinem/dgaa760 Clinical Research Article ISSN Print 0021-972X ISSN Online 1945-7197 Printed in USA e316 https://academic.oup.com/jcem © The Author(s) 2020. Published by Oxford University Press on behalf of the Endocrine Society. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com Clinical Research Article Quality of Life in Patients with Neuroendocrine Neoplasms: The Role of Severity, Clinical Heterogeneity, and Resilience Cristiano Scandurra, 1 Roberta Modica, 2 Nelson Mauro Maldonato, 1 Pasquale Dolce, 3 Greta G. Dipietrangelo, 4 Roberta Centello, 4 Valentina Di Vito, 4 Filomena Bottiglieri, 2 Federica de Cicco, 2 Elisa Giannetta, 4 Andrea M. Isidori, 4 Andrea Lenzi, 4 Benedetta Muzii, 5 Antongiulio Faggiano, 4 and Annamaria Colao 2 1 Department of Neuroscience, Reproductive Sciences and Dentistry, University of Naples Federico II, 80131 Naples, Italy; 2 Department of Clinical Medicine and Surgery, University of Naples Federico II, 80131 Naples, Italy; 3 Department of Public Health, University of Naples Federico II, 80131 Naples, Italy; 4 Department of Experimental Medicine, “Sapienza” University of Rome, 00161 Rome, Italy; and 5 Department of Humanistic Studies, University of Naples Federico II, 80133 Naples, Italy ORCiD numbers: 0000-0003-1790-3997 (C. Scandurra); 0000-0002-9037-5417 (A. M. Isidori). Received: 31 August 2020; Editorial Decision: 11 October 2020; First Published Online: 21 October 2020; Corrected and Typeset: 16 November 2020. Abstract  Context: Although health-related quality of life (HRQoL) is a fundamental outcome in oncological clinical trials, its evaluation in the neuroendocrine neoplasm (NEN) research field is still limited. Objectives: This study assessed the role of clinical severity (ie, presence or absence of metastasis and lines of therapies) and heterogeneity (ie, primary site, types of therapy, biology, and surgery) of NEN in relation to HRQoL, as well as resilience as a moderator between clinical severity and HRQoL. Design: Cross-sectional multicentric study. Setting: Italian university hospitals. Patients: A total of 99 Italian patients (53 men and 46 women) with NEN and ranged in age from 22–79 years old. Main Outcome Measure: Severity and heterogeneity of NENs, HRQoL, and resilience. Results: The presence of metastasis and a greater number of therapies affected the global health and some physical symptoms. Resilience was associated with global health, functional status, and some physical symptoms, and it moderated the impact of metastases on constipation and of the multiple therapies on diarrhea and financial problems. Patients with NEN in districts other than the gastroenteropancreatic system and those in follow-up perceived fewer physical symptoms than their counterparts. Patients with a sporadic NEN perceived their functional status, global health, and disease-related Downloaded from https://academic.oup.com/jcem/article/106/1/e316/5934547 by guest on 10 June 2022