Malnutrition and sarcopenia negatively affect treatment response and clinical outcomes in cancer patients. In gastroenteropancreatic neuroendocrine neoplasms (GEP-NENs), tumor location and hormone secretion may further exacerbate sarcopenia and its consequences. This study investigated the prevalence of malnutrition and sarcopenia in GEP-NEN patients and explored their associations with tumor characteristics, survival outcomes, and the expression of ghrelin system components in tumor tissue. A total of 104 patients were included. Anthropometric measurements, biochemical parameters, and CT scans at diagnosis were analyzed. Tumor expression of key ghrelin system components was assessed in 63 samples.
Nutritional status was comparable across tumors of different origins. Relapsed disease correlated with lower body mass index, and patients presenting with weight loss at diagnosis had significantly shorter overall survival (108 [25–302] vs. 263 [79–136] months). GOAT (ghrelin O-acyltransferase) expression was elevated in these patients. Sarcopenia was highly prevalent (87.2%), and mortality occurred exclusively in patients with sarcopenia. Muscle mass was associated with biochemical markers but showed no correlation with ghrelin system expression. Both nutritional status and expression of certain ghrelin system components are linked to survival in GEP-NEN patients. Regular nutritional assessment and timely interventions are recommended to improve clinical outcomes and quality of life.
