Nutritional and vitamin status in patients with neuroendocrine neoplasms

World J Gastroenterol. 2019 Mar 14;25(10):1171-1184. doi: 10.3748/wjg.v25.i10.1171.


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: Diarrhoea; Malnutrition; Neuroendocrine neoplasm; Nutrition; Steatorrhoea; Vitamin deficiency.

Publication types

  • Review

MeSH terms

  • Avitaminosis / etiology*
  • Avitaminosis / physiopathology
  • Avitaminosis / therapy
  • Diarrhea / etiology
  • Diarrhea / physiopathology
  • Diarrhea / therapy
  • Gastrointestinal Neoplasms / complications*
  • Gastrointestinal Neoplasms / mortality
  • Gastrointestinal Neoplasms / physiopathology
  • Humans
  • Malnutrition / diagnosis
  • Malnutrition / etiology*
  • Malnutrition / physiopathology
  • Malnutrition / therapy
  • Neuroendocrine Tumors / complications*
  • Neuroendocrine Tumors / mortality
  • Neuroendocrine Tumors / physiopathology
  • Nutritional Status / physiology*
  • Prognosis
  • Quality of Life
  • Trace Elements / deficiency
  • Vitamins / physiology


  • Trace Elements
  • Vitamins