Nutritional status and quality of life of patients with advanced gastroenteropancreatic neuroendocrine neoplasms in Spain: the NUTRIGETNE (GETNE-S2109) study

Patients with advanced gastroenteropancreatic neuroendocrine neoplasms (GEP-NENs) have impaired nutritional and physical performance due to the cancer pathophysiology and its treatment. The NUTRIGETNE study sought to characterize the nutritional status of patients with advanced GEP-NENs in Spain. This is a cross-sectional study that included patients with advanced GEP-NENs receiving active oncological treatment. Patients had a complete physical examination, anthropometry, bioelectrical impedance, dynamometry, laboratory analysis, and a comprehensive nutritional risk assessment. Malnutrition was defined according to Global Leadership Initiative on Malnutrition (GLIM) criteria. The study included 399 patients out of the 400 planned (Pearson's χ2; α 0.05). Median age was 62 years (22-83). Tumors most commonly originated in the small intestine (43.9%) and the pancreas (41.6%), 94.7% were metastatic, and 36.7%, 49.4%, and 12.5% were G1, G2, and G3, respectively. Malnutrition prevalence was 61.9% (25.8% moderate; 36.1% severe), mainly due to low muscle mass (50.9%), which was the most prevalent GLIM phenotypic criteria. Moreover, malnutrition showed a correlation with decreased hand grip strength (mean 23 vs 31.9 kg; P <.001) and phase angle (median 5o vs 5.6o; P <.001). The prevalence of sarcopenia was 15%. Malnutrition was more frequent in patients with diabetes (74.4% vs 56.7%; P <.001), NECs (82.1% vs 60.3%; P =.062), and in those treated with chemotherapy (71.2% vs 59.7%; P =.058), whereas it did not correlate with tumor origin (P =.507), histological grade (P =.781), or functionality (P =.465). Malnutrition was correlated to body mass index (BMI) (P =.015), although it was also diagnosed in a high proportion of patients with no weight loss (63%, 54.1%, and 65.1% of patients with normal BMI, overweight, and obesity, respectively). Cachexia was present in 109 (27.3%) patients. Malnutrition is very prevalent and commonly underdiagnosed in patients with GEP-NENs. It is associated with sarcopenia and a worse QoL, requiring a multifactorial nutritional assessment. Certain factors such as the presence of diabetes may require closer monitoring due to a higher risk of malnutrition.

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Journal
The Oncologist
Published
2025-02-01
DOI
https://doi.org/10.1093/oncolo/oyae343
Citations
7
Primary Topic
Neuroendocrine Tumor Research Advances
Type
article
Field-Weighted Citation Impact
8.13

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article

Nutritional status and quality of life of patients with advanced gastroenteropancreatic neuroendocrine neoplasms in Spain: the NUTRIGETNE (GETNE-S2109) study

Nuria Valdés, Lorena Hernandez-Rienda, André Vitor Protázio Garcia, Alejandro García‐Álvarez et al.
7 citations
The Oncologist
Neuroendocrine Tumor Research Advances
8.13
article

Nutritional status and quality of life of patients with advanced gastroenteropancreatic neuroendocrine neoplasms in Spain: the NUTRIGETNE (GETNE-S2109) study

Nuria Valdés, Lorena Hernandez-Rienda, André Vitor Protázio Garcia, Alejandro García‐Álvarez, Anna Casteràs, Miguel Sampedro‐Núñez, Ana Sofia Pais, Alvaro Ruiz Grandos, J.M. Cabezas Agrícola, Pilar Monge, María Argente, Josefina Biarnés, Marcos Melián, S. Palma-Milla, Jorge Hernando, Noemi Brox, Marta Bellver, Naoko Mato, Javier Molina‐Cerrillo, Paula Jiménez‐Fonseca, Rocio García‐Carbonero, Vicente Alonso, María Isabel Del Olmo-García, José Ángel Díaz-Pérez, Carlos F. Lopez, Beatríz Febrero, Teresa Alonso‐Gordoa, Lorena Suárez, Marta Diéguez, Miguel Ángel Martínez Olmos, Juan Francisco Merino-Torres, Carolina Gándara, Jaume Capdevila, Beatriz Antón-Pascual, Ana Custodio, Raquel Serrano, Marta Gómez, Lucia Díaz
article en
7 citations

Abstract

Patients with advanced gastroenteropancreatic neuroendocrine neoplasms (GEP-NENs) have impaired nutritional and physical performance due to the cancer pathophysiology and its treatment. The NUTRIGETNE study sought to characterize the nutritional status of patients with advanced GEP-NENs in Spain. This is a cross-sectional study that included patients with advanced GEP-NENs receiving active oncological treatment. Patients had a complete physical examination, anthropometry, bioelectrical impedance, dynamometry, laboratory analysis, and a comprehensive nutritional risk assessment. Malnutrition was defined according to Global Leadership Initiative on Malnutrition (GLIM) criteria. The study included 399 patients out of the 400 planned (Pearson's χ2; α 0.05). Median age was 62 years (22-83). Tumors most commonly originated in the small intestine (43.9%) and the pancreas (41.6%), 94.7% were metastatic, and 36.7%, 49.4%, and 12.5% were G1, G2, and G3, respectively. Malnutrition prevalence was 61.9% (25.8% moderate; 36.1% severe), mainly due to low muscle mass (50.9%), which was the most prevalent GLIM phenotypic criteria. Moreover, malnutrition showed a correlation with decreased hand grip strength (mean 23 vs 31.9 kg; P <.001) and phase angle (median 5o vs 5.6o; P <.001). The prevalence of sarcopenia was 15%. Malnutrition was more frequent in patients with diabetes (74.4% vs 56.7%; P <.001), NECs (82.1% vs 60.3%; P =.062), and in those treated with chemotherapy (71.2% vs 59.7%; P =.058), whereas it did not correlate with tumor origin (P =.507), histological grade (P =.781), or functionality (P =.465). Malnutrition was correlated to body mass index (BMI) (P =.015), although it was also diagnosed in a high proportion of patients with no weight loss (63%, 54.1%, and 65.1% of patients with normal BMI, overweight, and obesity, respectively). Cachexia was present in 109 (27.3%) patients. Malnutrition is very prevalent and commonly underdiagnosed in patients with GEP-NENs. It is associated with sarcopenia and a worse QoL, requiring a multifactorial nutritional assessment. Certain factors such as the presence of diabetes may require closer monitoring due to a higher risk of malnutrition.

The OncologistVol. 30(2)
Hebron University (PS), Kaiser Permanente Washington Health Research Institute (US), Universitat de València (ES), Hospital Universitario La Paz (ES), Instituto de Salud Carlos III (ES), Hospital Clínico San Carlos (ES), Hospital Universitari i Politècnic La Fe (ES), Institut d'Investigació Biomédica de Bellvitge (ES), Centro de Investigación Biomédica en Red Diabetes y Enfermedades Metabólicas Asociadas (ES), Instituto Maimónides de Investigación Biomédica de Córdoba (ES), Complejo Hospitalario Universitario de Santiago (ES), Marqués de Valdecilla University Hospital (ES), Hospital Universitario 12 De Octubre (ES), Fundación Instituto Valenciano de Oncología (ES), Institut Català d'Oncologia (ES), Centre for Biomedical Network Research on Rare Diseases (ES), Instituto de Investigación Marqués de Valdecilla (ES), Hospital Universitario Miguel Servet (ES), Hospital Universitario Reina Sofía (ES), Hospital Universitario de La Princesa (ES), Instituto de Investigación Sanitaria Aragón (ES), Hospital de Cruces (ES), Instituto de Investigación Sanitaria de Santiago (ES), Hospital Universitario Virgen de la Arrixaca (ES), Hospital Universitari de Girona Doctor Josep Trueta (ES), Hospital Universitario Ramón y Cajal (ES), Instituto de Investigación Sanitaria del Principado de Asturias (ES)
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