Clement Dominique S V M, Leerdam Monique E van, de Jong Soraya, Weickert Martin O, Ramage John K, Tesselaar Margot E T, Srirajaskanthan Rajaventhan
Kings Health Partners, ENETS Centre of Excellence, Institute of Liver Studies, King's College Hospital, London SE5 9RS, UK.
Department of Gastroenterology, King's College Hospital, London SE5 9RS, UK.
Cancers (Basel). 2023 Jan 27;15(3):782. doi: 10.3390/cancers15030782.
Sarcopenia in patients with cancer is associated with adverse outcomes such as shorter survival. However, there exists little evidence regarding the prevalence of sarcopenia in patients with metastatic gastroenteropancreatic neuroendocrine tumours (GEP-NETs). Patients with a histologically confirmed newly diagnosed metastatic GEP-NET between 2006 and 2018, CT scan, and anthropometric data at diagnosis were included in this study. CT scans were analysed for the presence of sarcopenia and correlated with overall survival (OS). In total, 183 patients, 87 male (48%), with a median age of 62 years (IQR 52-68 years), were included. In 44 patients (24%), there was a pancreas NET, and in 136 patients, there was a small bowel NET (74%). Sarcopenia was present in 128 patients (69%) and unrelated to BMI (median 25.1). There were significant survival differences between patients with pancreatic and small bowel NETs at 86 vs. 141 months, respectively ( = 0.04). For patients with pancreatic NETs, the presence of sarcopenia was independently associated with shorter OS (HR 3.79 95% CI 1.1-13.03, -value 0.035). A high prevalence of sarcopenia at the time of diagnosis of a metastatic GEP-NET was seen and associated with worse OS in patients with pancreatic NETs. Further research should focus on how to reverse sarcopenia and its impact on OS and/or quality of life.
癌症患者的肌肉减少症与不良预后相关，如生存期缩短。然而，关于转移性胃肠胰神经内分泌肿瘤（GEP-NETs）患者肌肉减少症的患病率，几乎没有证据。本研究纳入了2006年至2018年间组织学确诊的新诊断转移性GEP-NET患者、CT扫描以及诊断时的人体测量数据。分析CT扫描结果以确定是否存在肌肉减少症，并将其与总生存期（OS）相关联。总共纳入了183例患者，其中87例男性（48%），中位年龄为62岁（四分位间距52 - 68岁）。44例患者（24%）患有胰腺神经内分泌肿瘤，136例患者（74%）患有小肠神经内分泌肿瘤。128例患者（69%）存在肌肉减少症，且与体重指数无关（中位值25.1）。胰腺神经内分泌肿瘤和小肠神经内分泌肿瘤患者的生存期分别为86个月和141个月，存在显著差异（ = 0.04）。对于胰腺神经内分泌肿瘤患者，肌肉减少症的存在与较短的总生存期独立相关（风险比3.79，95%置信区间1.1 - 13.03， 值0.035）。转移性GEP-NET诊断时肌肉减少症的患病率较高，且与胰腺神经内分泌肿瘤患者较差的总生存期相关。进一步的研究应聚焦于如何逆转肌肉减少症及其对总生存期和/或生活质量的影响。
