Background: Up to 60% of patients with neuroendocrine tumours (NETs) are malnourished. This negatively impacts survival, length of hospital stay, risk of complications, treatment response, fatigue and quality of life. Malnutrition is typically defined by body mass index (BMI) or weight loss, which provides no information on body composition. Research in other cancers has shown sarcopenia is more significant than BMI. Information is lacking on the influence of anthropometric parameters in NETs.
Aims: To determine whether weight and BMI are indicative of body composition in patients with NETs.
Methods: Data for 433 patients seen by a specialist NET dietitian over 2 years was provided by bioinformatics. Of these, 41 patients had a full set of anthropometric data including; weight, BMI, handgrip strength (HGS), mid arm circumference (MAC), mid arm muscle circumference (MAMC) and triceps skinfold thickness (TSF).
Results: Of the 41 patients included, mean BMI was categorised as healthy at 23.1 kg/m2 (range: 15.2-38.2 kg/m2), only 12% of patients were underweight (BMI <18.5 kg/m2). However, 93% of patients had a MAC <50th centile, 85% had a TSF <50th centile and 82% had a MAMC <50th centile when compared to normal for their age and gender. Mean HGS was 81% (24 kg) of normal for patients age and gender, range was 51-144% (13.1-47.4kg). A correlation coefficient of 0.21 was found between BMI and HGS, 0.62 for BMI and MAMC and 0.31 between BMI and TSF.
Conclusion: Despite the majority of patients having healthy BMIs, upper body muscle mass, fat mass and grip strength were mostly below average and there is a poor correlation between different measurement methods. Standard nutritional assessment is likely inadequate. Further research is required.