Nutritional aspects in neuroendocrine neoplasms. bridging the gap between dietary interventions and cancer care strategies: a scoping review.

Ambra Ciliberto, Alessandra Zilli, Francesco Panzuto, Silvio Danese, Sara Massironi, Alessandro Laviano, Elena Romano, Maria Rinzivillo

Journal: Journal of endocrinological investigation 2025;48(2):269-281

PMID: 39395115

Abstract

PURPOSE

Neuroendocrine neoplasms (NENs) represent heterogeneous tumors arising from neuroendocrine cells in different organs. Despite growing interest in the nutritional aspects of NEN management, research in this area is limited. Aim of this review is to summarize the current state of knowledge, highlight research gaps, and underscore the significance of nutrition in the comprehensive care of NEN patients.

METHODS

We conducted an extensive bibliographic search focusing on studies (including retrospective and prospective studies, systematic reviews, case series, and guidelines) exploring the relationship between nutritional assessments, dietary interventions, micronutrient deficiencies, and their impact on NEN outcomes.

RESULTS

Significant gaps exist in current research, particularly in understanding the specific nutritional needs of NEN patients and how tailored nutritional interventions can improve clinical outcomes. Evidence suggests that a high-fat Western diet may promote the growth of NEN, while a Mediterranean diet may help lower insulin levels and strengthen the immune system, potentially preventing tumor development. The ketogenic diet and intermittent fasting may also have positive impacts. Addressing common micronutrient deficiencies, such as vitamin D and niacin, is crucial to mitigate disease progression. There's a crucial need for future studies to include a comprehensive nutritional assessment incorporating patient-reported outcomes, to fully capture the impact of nutritional strategies.

CONCLUSION

Nutritional management, an important but under-researched facet of NEN treatment, significantly improves patients' quality of life and survival. Integrating nutrition into personalized cancer care is essential, highlighting the role of nutritional strategies in optimizing patient outcomes.

© 2024. The Author(s).

Address: Division of Gastroenterology Fondazione, IRCCS San Gerardo dei Tintori, Monza, Italia. [email protected].; Division of Gastroenterology, San Gerardo Hospital, Via Pergolesi 3, Monza, Italy. [email protected].; Department of Surgical-Medical Sciences and Translational Medicine, Digestive Disease Unit, Sapienza University of Rome, Sant'Andrea University Hospital, ENETS Center of Excellence, Rome, Italy.; Gastroenterology and Endoscopy, IRCCS San Raffaele Hospital, Milan, Italy.; Gastroenterology and Endoscopy, IRCCS San Raffaele Hospital, Milan, Italy.; Vita-Salute San Raffaele University, Milan, Italy.; Department of Translational and Precision Medicine, Clinical Nutrition Unit, Sapienza University of Rome, Sant'Andrea University Hospital, Rome, Italy.

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