Abstract: Rationale: Patients with advanced GEP-NENs often present with metabolic disorders and oncological treatments may increase malnutrition risk. Methods: Cross-sectional study in patients with metastic/unresectable GEP-NENs and active oncological treatment.Demographic evaluation,physical examination,bioelectrical impedance,dynamometry,analysis, and nutritional risk assessment were performed.Malnutrition was defined according to GLIM criteria and sarcopenia according EWGSOP.The study plans to include 400 patients; Accrual is open. Results: 284 patients,age 63 years(24-83).Most frequent tumor location was small bowel(44.7%). 88.4% G1-2 and 83.8% had ECOG 0-1, and 23.6% were functioning. The most common treatments were somatostatin analogues(89.8%), targeted therapy(29.9%), PRRT(28.9%) and chemotherapy(CT)(19.7%). Malnutrition prevalence was 62%(176) being severe in 37,7%(107).Low muscle mass was present in 139(48.9%) patients and being severe in 25.7%. Mean calf circumference was 34.2(4.8)cm and 36.5(5.5)cm, free fat mass of 41.4(10.6)kg and 56.1(11.8)kg and handgrip strength of 19.2(6.9)kg and 36.3(9.5)kg in females and males respectively. Patients with malnutrition showed decreased handgrip strength (p< 0.001).Sarcopenia was present in 22.5%. Malnutrition was more frequent in patients with ECOG >1(100% vs 60.7%;p= 0.002) and those treated with CT (75% vs 59.8%;p=0.036). Malnutrition diagnosis didn?t correlate with primary tumor location, grade or functionality. Conclusion: Malnutrition among patients with advanced GEP-NENs is high, independently on tumor location, grade or functionality.Low muscle mass is the most frequent phenotypic criteria present in half of the patients.One every five patients had sarcopenia.

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