Endocrine Abstracts

Introduction: Patients with neuroendocrine tumours (NETs) and carcinoid syndrome are at risk of developing carcinoid heart disease (CaHD). Sarcopenia is a muscle disease, associated with poorer overall survival and post operative complications in other types of cancer. In patients with NETs sarcopenia is highly prevalent, if this effects complications and survival following surgery for CaHD is unknown.The aim of this study is to describe the prevalence of sarcopenia and to assess its association with post operative complications and overall survival in patients with NETs and CaHD.

Methods: A single centre retrospective study was performed. Patients with CaHD and valve replacement surgery were included. An abdominal CT scan performed within 3 months of the surgery was analysed for sarcopenia. Additional data regarding post operative complications and overall survival were collected and analysed.

Results: A total of 27 patients, n = 14 (52%) male with a median age 62 year (IQR 52 – 70yr) were identified. The primary tumour was located in the small bowel in n = 26 patients (96%) and ovaries in 1 patient (4%). Eleven patients (41%) presented with heart failure as first symptom of a NET. In 18 patients there was sarcopenia present (67%), those patients were significant older (p-value 0.04) compared to the patients without sarcopenia. A median of 2 heart valves (IQR 2-3) were replaced. In 9 patients (33%) post operative complications were reported, 4 (44%) of these were severe. However, sarcopenia was not associated with post operative complications. Two patients died within 30-days postoperative. The median overall survival following surgery was 49 months (IQR 25 – 73 months). There were no survival differences in patients without or with sarcopenia (p-value 0.41).

Conclusion: In this small study population sarcopenia is highly prevalent in patients with NETs and CaHD, however it is not associated with post-operative complications or overall survival following surgery. Future studies should include a larger study population and investigate sarcopenia into more detail for example with muscle strength and physical performance to elucidate its true prevalence, once this is more clear the role of sarcopenia in patients with NETs and CaHD could be investigated further.