Introduction: Patients with neuroendocrine tumours located in the gastroenteropancreatic tract (GEP-NETs) and treatment with somatostatin analogues (SSAs) are at risk of malnutrition which has been reported previously, based on weight loss or body mass index (BMI) only. Since 2019 The Global leadership into malnutrition (GLIM) criteria exist to diagnose malnutrition, including weight loss, BMI and sarcopenia. These GLIM criteria have not been assessed in patients with GEP-NETs using SSAs. In non-NET cancers the presence of malnutrition, has a negative effect on overall survival. In patients with GEP-NETs using SSAs this has not been explored before.
The aim: To describe the presence of malnutrition in patients with GEP-NETs using SSAs based on the GLIM criteria and correlate this with overall survival.
Methods: Cross-sectional study with single screening patients with GEP-NETs using SSAs for malnutrition using the GLIM criteria. Body composition analysis for sarcopenia diagnosis were performed. Overall survival since the date of nutrition screening was calculated. Uni- and multivariate Cox regression analysis were performed to identify malnutrition as risk factor for overall survival.
Results: A total of 118 patients, 47% male, with median age 67 year (IQR 56.8 75.0) were included. Overall, malnutrition was present in 88 patients (75%); based on low BMI in 26 (22%), based on weight loss in 35 (30%), and based on sarcopenia in 83 (70%). The presence of malnutrition demonstrated a significantly worse overall survival (p-value 0.01). In multivariate analysis meeting 2 or 3 GLIM criteria was significantly associated with worse overall survival (HR 2.16 95% CI 1.34 3.48, p-value 0.002). Weight loss was the most important risk factor out of the 3 GLIM criteria (HR 3.5 95% CI 1.14 10.85, p-value 0.03) for worse overall survival.
Conclusion: A high percentage (75%) of patients with GEP-NETs using SSAs meet the GLIM criteria for malnutrition. Meeting more than 1 GLIM criterium, especially if there is weight loss these are risk factors for worse overall survival. Patients could benefit from regular weight monitoring and possibly from early nutritional intervention. Future research should focus on the effect of nutritional interventions and overall survival.