Endocrine Abstracts

JOINT214

Introduction: Sarcopenia is characterized by loss of skeletal muscle mass and quality, numerous studies have reported an association between sarcopenia and poor outcomes in various malignancies. There is limited data regarding lean body mass status in patients with neuroendocrine tumors (NETs). Skeletal muscle mass index (SMI), measured by computed tomography (CT) scans, is considered a gold standard for determining body composition in diagnosing sarcopenia.

Aim: To measure the prevalence of sarcopenia in patients newly diagnosed with intestinal and pancreatic NETs, evaluate its association with patient characteristics, and explore its potential impact on overall survival.

Methods: This retrospective cohort study reviewed the medical records of 145 patients diagnosed with intestinal or pancreatic NETs at Tel Aviv Sourasky Medical Center (TLVMC) from 2005 to 2020. CT scans, taken near the diagnosis date, were analyzed for the presence of sarcopenia. Abdominal CT slices, which displayed the cross-sectional area of Lumbar vertebra 3 (L3), were analyzed using Coreslicer software based on established cutoffs for sarcopenia diagnosis. Statistical methods, including survival analysis and Cox regression, were used to assess the adjusted risk factors of sarcopenia prevalence on overall survival.

Outcomes: Sarcopenia was identified in 41% of the cohort, with a significant association between sarcopenia and older age (P = 0. 013). Sarcopenic patients also exhibited a higher prevalence of cardiovascular disease (19% vs. 5. 8%, P = 0. 014) and lower median body mass index (BMI: 25. 3 vs. 27. 5 kg/m², P = 0. 002). Despite these associations, sarcopenia did not emerge as a significant predictor of overall survival. Weight loss was present in 17% of patients (median weight loss of 10. 5 kg, IQR 6-17 kg), with 60% of those experiencing weight loss also diagnosed with sarcopenia. Additionally, the moderate correlation between BMI and skeletal muscle index (R² = 0. 44, P < 0. 001) highlights the limitations of BMI in reflecting muscle depletion in this cohort. These findings emphasize the need for muscle mass evaluation independent of BMI.

Conclusions: Sarcopenia is a prevalent and age-associated condition in NET patients, often coexisting with normal or elevated BMI. Its detection is crucial for early nutritional intervention, though it may not independently predict survival in heterogeneous NET populations. These findings underscore the importance of standardized sarcopenia assessment at diagnosis and encourage further research into its prognostic value in homogeneous NET subgroups.