Bone health in neuroendocrine tumors and prognostic implications beyond skeletal metastases
Abstract
Background: The potential impact of NET (neuroendocrine tumor)-related disease burden on musculoskeletal health remains inconclusive.
Aim: To assess the musculoskeletal status, its prognostic relevance and association with tumor aggressiveness in NET patients.
Materials and methods: This cross-sectional study included 41 patients with grade (G) 1, 2, or 3 gastroenteropancreatic (GEP) and lung NETs. Among them, 38 were selected for comparison with 47 healthy controls matched for age, sex and body mass index (BMI). The musculoskeletal health was assessed by dual-energy X-ray absorptiometry (DXA) scan.
Results: Within the NET group (median age=72 years old, 46% women), degraded TBS (trabecular bone score) was found in 71% of patients, with osteopenia affecting up to 59% at the femoral neck. The prevalence of hypovitaminosis D was 68%, whereas of low RSMI (relative skeletal muscle index) suggestive of sarcopenia 37%. Patients with advanced-stage NETs showed significantly lower L1-L4 BMD (bone mineral density), L1-L4 T-score, L1-L4 Z-score, 25-hydroxyvitamin D [25(OH)D] levels and BMI than those with earlier-stage disease. G2 NETs were associated with worse L1-L4 BMD, L1-L4 T-score, total hip T-score and diaphysis BMD than G1 NETs. In multivariate analysis, higher 25(OH)D levels and BMI were independently associated with longer progression-free survival (PFS), whereas higher Ki-67 was associated with shorter PFS. Correlation analyses showed inverse associations between Ki-67 and…
How strong is the evidence?
Evidence Hub reads this as a case-control, done in people. Its evidence level is 4 of 5 (Low · observational). Observational designs can show an association but not prove cause. Reported size: 41 participants or records.
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