Gastroenteropancreatic neuroendocrine tumours (GEP NET) can adversely affect nutritional status. Cross-sectional studies report up to 25% of GEP NET patients are malnourished and dietary change may be prevalent. Nevertheless, clinical guidelines lack advice on nutritional management.
To describe the impact of a GEP NET on nutritional status and quality of life.
Material and Methods
People diagnosed with a GEP NET were recruited to this prospective longitudinal study on initial attendance to the NET Unit at two tertiary hospitals in Melbourne, Australia. Self-report measures (EORTC QLC-C30 and -GINET21) and nutritional outcomes (nutritional status, weight change, fat-free mass (FFM), dietary change, dietitian contact) were gathered bi-monthly for six months.
Sixty-one participants were recruited (M=62 years; 66% male). Tumour grading and primary site varied (29% NET G1, 37% NET G2, 17% NET G3; 46% small intestine, 36% pancreas). Fatigue, abdominal discomfort and pain were common (64-80%). More participants were malnourished at baseline than 6 months later (29% versus 13%, p=0.23), yet 36% lost weight over this time; 20% lost >5% of their body weight and 44% lost FFM, with an average FFM loss of 2.8kg (95% CI=2.0, 3.6), indicating altered body composition. Dietary change was reported by 56% at baseline and 53% at 6 months. Only 21% saw a dietitian at baseline and 18% at 6 months.
Symptoms impacting on diet are common in patients with a GEP NET and clinically significant loss of weight and FFM occur over time; yet, few patients are seen by a dietitian. Valid screening practices are needed to identify weight loss and nutrition issues, and facilitate referral to dietitian services.