Endocrine Abstracts

Background: Neuroendocrine tumors (NETs) are characterized by long survival and slow progression. In the clinical practice adifferent types of endocrine-metabolic disorders can occur. Such disorders are either comorbidities related to the neoplasm or side effects of specific oncological treatments. The aim of this study is to evaluate type and prevalence of the endocrine-metabolic disorders in patients with gastroenteropancreatic (GEP) and lung NETs.

Materials and Methods: This single-center study evaluated 58 consecutive patients with sporadic NEN, referring to the ENETS Center in Rome (Sant’Andrea Hospital) from November 2020 to December 2021. Of them 31(53.4%) were affected by GEP NET and 27 (46.6%) by bronchial carcinoid. Twenty patients underwent surgical resection, 12 medical therapy and 26 combined therapies. All patients underwent clinical and biochemical screening for endocrine-metabolic disorders at the baseline and during the follow-up.

Results: Fifty-six over 58 patients (96.6%) were affected by at least one metabolic endocrine disorder. Thyroid dysfunctions were detected in 19 patients (33.9%), including primary hypothyroidism in 16 patients and central hypothyroidism in 1 patient. Six of them occurred after NET diagnosis: 1 after somatostatin analogues (SSA); 2 after targeted therapy and 3 after surgery. Subclinical hyperthyroidism occurred in 2 patients after SSA therapy. Impaired fasting glucose occurred in 23 subjects (41%) and was detected after NET diagnosis in 20 patients (5 after SSA, 4 after surgery, 1 after targeted therapy and 10 after combined therapy). Diabetes occurred in 12 subjects (21.4%) and was detected after NET diagnosis in 8 patients (3 after surgery, 1 after SSA, 1 after targeted therapy and 3 after combined therapy). Dyslipidemia occurred in 23 subjects (41%) and was detected after NET diagnosis in 9 patients (2 after surgery, 1 after targeted therapy and 5 after combined therapy). Hypovitaminosis D occurred in 36 subjects (64.3%) and was detected after NET diagnosis in 19 patients (5 after surgery, 5 after SSA and 9 after combined therapy). Primary hypogonadism occurred in 2 patients and central hypogonadism in 1 patient. Primary adrenal insufficiency occurred in 2 patients after surgery and after SSA respectively, 1 patient was affected by Cushing Syndrome detected after combined therapy.

Conclusions: NET patients represent a high-risk population for the development of endocrine-metabolic disorders. The most frequent alterations are hypovitaminosis D, dyslipidemia and glucose impairment, mainly occurring after medical therapy and/or surgery. In all patients with NET a screening of endocrine-metabolic disorders at diagnosis and during the follow-up is strongly recommended.