EYES2023 ESE Young Endocrinologists and Scientists (EYES) 2023 Oral communication 3: Adrenal Tumors and Neuroendocrine Tumors (7 abstracts)
Bone fragility in well-differentiated gastroenteropancreatic-neuroendocrine tumors: Results from a retrospective two-centered study
Alessandro Brunetti 1 , Simona Jaafar 1 , Isabella Chiardi 2 , Miriam Cellini 3 , Antonio Stefano Salcuni 3 , Stella Pigni 1 , Elisabetta Lavezzi 1 , Andrea Lania 1 , Gherardo Mazziotti 1 & Fabio Vescini 3
1Irccs Humanitas Research Hospital, Endocrinology, Diabetology and Andrology Unit, Rozzano (Mi), Italy; 2Humanitas University, Department of Biomedical Sciences, Pieve Emanuele (Mi), Italy; 3University-Hospital S. Maria Della Misericordia, Endocrinology and Metabolism Unit, Udine, Italy.
Background: Patients affected by gastroenteropancreatic-neuroendocrine tumors (GEP-NETs) present an increased risk of bone fragility due to several factors, such as bone metastases, vitamin D deficiency, hormonal secretion, medical and surgical treatments. Although patients with well-differentiated GEP-NETs generally present a long life-expectancy, occurrence of fragility fractures could significantly impair quality of life.
Objectives: The study aims to investigate prevalence and risk factors for fragility fractures in patients with well-differentiated, G1-G2, GEP-NET.
Methods: We included 292 patients, 154 men and 138 women, with G1-G2 GEP-NETs admitted in the last year (July 1st, 2022, to July 1st, 2023) in our two hospitals, Humanitas Research Hospital, Milan, and Hospital S. Maria della Misericordia, Udine. Reports about clinical fractures, disease course and treatments were retrospectively collected from patients’ clinical charts from time of diagnosis to the last follow-up visit (mean follow-up 60 months). Morphometric fractures were assessed according to Genant classification by reviewing chest-abdomen CT or MRI performed both at diagnosis and during follow-up.
Results: At diagnosis, 6.8% of patients had a history of clinical fractures and 11.5% had morphometric fractures. Vitamin D deficiency (<30 ng/ml) and severe insufficiency (<10 ng/ml) were found in 70% and 17.5% of patients, respectively. Baseline fractures (clinical or morphometric) were significantly more frequent in patients with vitamin D deficiency, than in those with normal values (P<0.05). No difference in term of hormonal secretion, disease staging or grading was found between fractured and non-fractured patients. Notably, only 20% of patients underwent anti-resorptive therapy during follow-up and 9.8% developed a new fracture. Risk of new fractures was significantly higher in patients already fractured at diagnosis compared to non-fractured (P<0.01), independently from surgical or medical treatments.
Conclusions: Fragility fractures are frequent in GEP-NETs and keep often undiagnosed and untreated. Attention to bone health should be part of the clinical management of these patients.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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