Endocrine Abstracts

Introduction: Malnutrition is a common problem amongst patients with gastro-enteropancreatic neuroendocrine tumours (GEP-NETs). A recent study from our group reported 75% of patients with GEP-NETs treated with monthly somatostatin analogues (SSAs) are malnourished (1). Ideally, all malnourished patients are offered nutritional support. However, guidelines and support are often lacking. The natural course of malnutrition in patients with GEP-NETs is unknown.The aim of this study is to describe a 5-year follow-up of a cohort of patients with GEP-NETs treated with monthly SSAs.

Methods: A prospective longitudinal single-centre cohort study was performed including patients with GEP-NETs treated with SSAs. The data of this cohort were analysed after 5-years. Baseline data were compared with 5-year follow-up. Analyses focussed on BMI, nutrition status using the malnutrition-universal-screening-tool (MUST), and vitamin-D deficiencies.

Results: The initial study population included 118 patients, after 5 years for 71 patients data were available and analysed. There were 29 male patients (41%) with median age of 69 years (IQR 60-76.5) and 16 patients (23%) had progressive disease. At baseline 35 patients (30%) had a positive MUST score (≥1) and 19 patients (16%) had a MUST score >2. After 5 years 28 patients (39%) had a positive MUST score (≥1) of which 19 patients (27%) had a MUST score >2. Overall, 41% of patients underwent dietitian review at any point from baseline. Patients deceased at the point of follow-up were more likely to have a positive MUST score (83% vs 31%, p<0.05). Although there was a trend towards increased prevalence of malnutrition in patients with progressive disease (53% vs. 31%), this did not reach statistical significance. At baseline, vitamin-D deficiency (≤ 25 ng/mL) was shown in 5 (7.0%), and vitamin-D insufficiency (25-50 ng/mL) was shown in 32 (45%). At follow-up, vitamin-D deficiency was shown in n = 8 (11%), and vitamin-D insufficiency in 24 (32%) of patients.

Conclusion: This long-term follow-up study shows patients with GEP-NETs and monthly SSA treatment are at risk of malnutrition. Malnourished patients show a worse prognosis. This highlights the importance of nutritional support and guidelines. Future research should focus on improving nutritional status and developing nutrition guidelines.