Exploring health professional knowledge and management of nutritional complications in neuroendocrine cancer patients: Results of an international multidisciplinary survey

Laing, Erin; Kiss, Nicole; Krishnasamy, Meinir; Gough, Karla; Michael, Michael

doi:10.1016/j.clnesp.2022.02.124

Cited by 2 publications

(4 citation statements)

References 39 publications

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Section: Discussionmentioning

confidence: 99%

“…Patients with GEP-NETs can experience various nutritional issues such as nutrient malabsorption, vitamin deficiencies, food intolerance, and malnutrition related to local and systemic sites of disease, paraneoplastic hormonal syndromes or treatment-related symptoms [20, 28]. For example, up to 29% of patients with GEP-NETs may be malnourished, while food intolerance and diarrhea has been reported in up to 90% and 80% of patients, respectively [12, 17, 28, 29]. Given the lack of NET-specific nutrition guidelines, an international health professional survey was recently published to provide guidelines on nutritional screening, assessment and intervention among at-risk patients with NETs [28].…”

Section: Discussionmentioning

confidence: 99%

“…For example, up to 29% of patients with GEP-NETs may be malnourished, while food intolerance and diarrhea has been reported in up to 90% and 80% of patients, respectively [12, 17, 28, 29]. Given the lack of NET-specific nutrition guidelines, an international health professional survey was recently published to provide guidelines on nutritional screening, assessment and intervention among at-risk patients with NETs [28]. According to current guidelines, given that NET patients with malnutrition have a higher risk of complications and mortality, nutritional screening is recommended for all NET patients.…”

Section: Discussionmentioning

confidence: 99%

“…Clinical symptoms are common among patients with GEP-NETs [17, 20, 28]. The hypersecretion of hormones and peptides including gastrin, glucagon and insulin may lead to specific hormonal syndromes such as Zollinger-Ellison syndrome, diabetes mellitus, and hypoglycemia.…”

Section: Discussionmentioning

confidence: 99%

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Low Prognostic Nutritional Index Is Common and Associated with Poor Outcomes following Curative-Intent Resection for Gastro-Entero-Pancreatic Neuroendocrine Tumors

Xiang,

Qian,

et al. 2023

Neuroendocrinology

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Introduction: To investigate the impact of prognostic nutritional index (PNI) on short- and long-term outcomes of patients who underwent curative-intent resection for gastro-entero-pancreatic neuroendocrine tumors (GEP-NETs). Methods: Patients with GET-NETs who underwent curative-intent resection were identified from a multi-center database. The prognostic impact of clinicopathological factors including PNI on post-operative outcomes were evaluated. A novel nomogram was developed and externally validated. Results: A total of 2,099 patients with GEP-NETs were included in the training cohort; 255 patients were in the external validation cohort. Median PNI (n = 973) was 47.4 (IQR 43.1–52.4). At the time of presentation, 1,299 (61.9%) patients presented with some type of clinical symptom. Low-PNI (≤42.2) was associated with gastrointestinal symptoms, as well as nodal metastasis and distant metastasis (all p < 0.05). Patients with a low PNI had a higher incidence of severe (≥Clavien-Dindo grade IIIa: low PNI 24.9% vs. high PNI 15.4%, p = 0.001) and multiple (≥3 types of complications: low PNI 14.5% vs. high PNI 9.2%, p = 0.024) complications, as well as a worse overall survival (OS)(5-year OS, low PNI 73.7% vs. high PNI 88.5%, p < 0.001), and RFS (5-year RFS, low PNI 68.5% vs. high PNI 79.8%, p = 0.008) versus patients with high PNI (>42.2). A nomogram based on PNI, tumor grade and metastatic disease demonstrated excellent discrimination and calibration to predict OS in both the training (C-index 0.748) and two external validation (C-index 0.827, 0.745) cohorts. Conclusions: Low PNI was common and associated with worse short- and long-term outcomes among patients with GEP-NETs.

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