title: Screening for malnutrition in patients with gastro-entero-pancreatic neuroendocrine tumours: a cross-sectional study.
abstract: To investigate whether screening for malnutrition using the validated malnutrition universal screening tool (MUST) identifies specific characteristics of patients at risk, in patients with gastro-entero-pancreatic neuroendocrine tumours (GEP-NET).
  
  
  
  Cross-sectional study.
  
  
  
  University Hospitals Coventry & Warwickshire NHS Trust; European Neuroendocrine Tumour Society Centre of Excellence.
  
  
  
  Patients with confirmed GEP-NET (n=161) of varying primary tumour sites, functioning status, grading, staging and treatment modalities.
  
  
  
  To identify disease and treatment-related characteristics of patients with GEP-NET who score using MUST, and should be directed to detailed nutritional assessment.
  
  
  
  MUST score was positive (≥1) in 14% of outpatients with GEP-NET. MUST-positive patients had lower faecal elastase concentrations compared to MUST-negative patients (244±37 vs 383±20 µg/g stool; p=0.018), and were more likely to be on treatment with long-acting somatostatin analogues (65 vs 38%, p=0.021). MUST-positive patients were also more likely to have rectal or unknown primary NET, whereas, frequencies of other GEP-NET including pancreatic NET were comparable between MUST-positive and MUST-negative patients.
  
  
  
  Given the frequency of patients identified at malnutrition risk using MUST in our relatively large and diverse GEP-NET cohort and the clinical implications of detecting malnutrition early, we recommend routine use of malnutrition screening in all patients with GEP-NET, and particularly in patients who are treated with long-acting somatostatin analogues.
authors.affiliation: The ARDEN NET Centre, European Neuroendocrine Tumour Society (ENETS) Centre of Excellence (CoE), University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK.
authors.forename: Sheharyar A
authors.initials: SA
authors.lastname: Qureshi
authors.affiliation: The ARDEN NET Centre, European Neuroendocrine Tumour Society (ENETS) Centre of Excellence (CoE), University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK.
authors.forename: Nicola
authors.initials: N
authors.lastname: Burch
authors.affiliation: Department of Endocrinology, Barts and the London School of Medicine, London, UK.
authors.forename: Maralyn
authors.initials: M
authors.lastname: Druce
authors.affiliation: Human Metabolic Research Unit, University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK.
authors.forename: John G
authors.initials: JG
authors.lastname: Hattersley
authors.affiliation: The ARDEN NET Centre, European Neuroendocrine Tumour Society (ENETS) Centre of Excellence (CoE), University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK.
authors.forename: Saboor
authors.initials: S
authors.lastname: Khan
authors.affiliation: The ARDEN NET Centre, European Neuroendocrine Tumour Society (ENETS) Centre of Excellence (CoE), University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK.
authors.forename: Kishore
authors.initials: K
authors.lastname: Gopalakrishnan
authors.affiliation: The ARDEN NET Centre, European Neuroendocrine Tumour Society (ENETS) Centre of Excellence (CoE), University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK.
authors.forename: Catherine
authors.initials: C
authors.lastname: Darby
authors.affiliation: The ARDEN NET Centre, European Neuroendocrine Tumour Society (ENETS) Centre of Excellence (CoE), University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK.
authors.forename: John L H
authors.initials: JL
authors.lastname: Wong
authors.affiliation: The ARDEN NET Centre, European Neuroendocrine Tumour Society (ENETS) Centre of Excellence (CoE), University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK.
authors.forename: Louise
authors.initials: L
authors.lastname: Davies
authors.affiliation: The ARDEN NET Centre, European Neuroendocrine Tumour Society (ENETS) Centre of Excellence (CoE), University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK.
authors.forename: Simon
authors.initials: S
authors.lastname: Fletcher
authors.affiliation: The ARDEN NET Centre, European Neuroendocrine Tumour Society (ENETS) Centre of Excellence (CoE), University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK.
authors.forename: William
authors.initials: W
authors.lastname: Shatwell
authors.affiliation: The ARDEN NET Centre, European Neuroendocrine Tumour Society (ENETS) Centre of Excellence (CoE), University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK.
authors.forename: Sharmila
authors.initials: S
authors.lastname: Sothi
authors.affiliation: The ARDEN NET Centre, European Neuroendocrine Tumour Society (ENETS) Centre of Excellence (CoE), University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK Division of Translational & Systems Medicine, Warwick Medical School, University of Warwick, Coventry, UK Coventry University, Centre for Applied Biological and Exercise Sciences, Coventry, UK.
authors.forename: Harpal S
authors.initials: HS
authors.lastname: Randeva
authors.affiliation: The ARDEN NET Centre, European Neuroendocrine Tumour Society (ENETS) Centre of Excellence (CoE), University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK Division of Translational & Systems Medicine, Warwick Medical School, University of Warwick, Coventry, UK.
authors.forename: Georgios K
authors.initials: GK
authors.lastname: Dimitriadis
authors.affiliation: The ARDEN NET Centre, European Neuroendocrine Tumour Society (ENETS) Centre of Excellence (CoE), University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK Division of Translational & Systems Medicine, Warwick Medical School, University of Warwick, Coventry, UK Coventry University, Centre for Applied Biological and Exercise Sciences, Coventry, UK.
authors.forename: Martin O
authors.initials: MO
authors.lastname: Weickert
mesh_terms: D000970:Antineoplastic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D015415:Biomarkers / Q000378:metabolism; D003430:Cross-Sectional Studies; D004739:England / Q000453:epidemiology; D005260:Female; D005770:Gastrointestinal Neoplasms / Q000150:complications / Q000188:drug therapy* / Q000378:metabolism; D006728:Hormones / Q000009:adverse effects* / Q000627:therapeutic use; D006801:Humans; D008297:Male; D044342:Malnutrition / Q000139:chemically induced*; D008875:Middle Aged; D018358:Neuroendocrine Tumors / Q000150:complications / Q000188:drug therapy* / Q000378:metabolism; D010190:Pancreatic Neoplasms / Q000150:complications / Q000188:drug therapy* / Q000378:metabolism; D017410:Practice Guidelines as Topic; D013004:Somatostatin / Q000009:adverse effects* / Q000031:analogs & derivatives / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D015415:Biomarkers; D006728:Hormones; D013004:Somatostatin
keywords: MUST malnutrition universal screening tool; exocrine pancreatic insufficiency; malnutrition; neuroendocrine tumours; somatostatin analogues