Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Mar 14, 2019; 25(10): 1171-1184
Published online Mar 14, 2019. doi: 10.3748/wjg.v25.i10.1171
Nutritional and vitamin status in patients with neuroendocrine neoplasms
Dominique SVM Clement, Margot ET Tesselaar, Monique E van Leerdam, Rajaventhan Srirajaskanthan, John K Ramage
Dominique SVM Clement, Rajaventhan Srirajaskanthan, John K Ramage, Neuroendocrine Tumour Unit, King’s College Hospital ENETS Centre of Excellence, London SE5 9RS, United Kingdom
Margot ET Tesselaar, Department of Medical Oncology, Netherlands Cancer Institute ENETS Centre of Excellence, Amsterdam 1066 CX, Netherlands
Monique E van Leerdam, Department of Gastrointestinal Oncology, Netherlands Cancer Institute, Amsterdam 1066 CX, Netherlands
Rajaventhan Srirajaskanthan, Department of Gastroenterology, King’s College Hospital, London SE5 9RS, United Kingdom
Author contributions: Clement DSVM, Tesselaar MET, Srirajaskanthan R, and Ramage JK wrote the manuscript; Clement DSVM generated the figures; van Leerdam ME reviewed the manuscript; Srirajaskanthan R designed the aim; Ramage JK designed the editorial.
Conflict-of-interest statement: No conflict of interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Corresponding author: Dominique SVM Clement, MD, Clinical Research Fellow, Neuroendocrine Tumour Unit, King’s College Hospital ENETS Centre of Excellence, Denmark Hill, London SE5 9RS, United Kingdom.
Telephone: +44-2032996043 Fax: +44-2032991778
Received: December 5, 2018
Peer-review started: December 6, 2018
First decision: January 18, 2019
Revised: February 13, 2019
Accepted: February 22, 2019
Article in press: February 23, 2019
Published online: March 14, 2019

Symptoms of gastroenteropancreatic located neuroendocrine neoplasms (GEP-NENs) are often related to food intake and manifest as abdominal pain or diarrhoea which can influence patients nutritional status. Malnutrition is common in cancer patients and influences quality of life, treatment options and survival but is also present in up to 40% of patients with GEP-NENs. As part of malnutrition there are often deficiencies in fat-soluble vitamins, mainly vitamin D. Little knowledge exists on trace elements. Several factors influence the development of malnutrition such as size and localisation of the primary tumour as well as metastases, side effects from treatment but also hormone production of the tumour itself. One of the main influencing factors leading to malnutrition is diarrhoea which leads to dehydration and electrolyte disturbances. Treatment of diarrhoea should be guided by its cause. Screening for malnutrition should be part of routine care in every GEP-NEN patient. Multidisciplinary treatment including dietician support is necessary for all malnourished patients with GEP-NENs.

Keywords: Neuroendocrine neoplasm, Nutrition, Malnutrition, Vitamin deficiency, Diarrhoea, Steatorrhoea

Core tip: Patients with gastroenteropancreatic located neuroendocrine neoplasms have a high risk on malnutrition and vitamin deficiency. Multidisciplinary treatment focussing on diarrhoea and nutritional status is warranted.