Endocrine Abstracts

Carcinoid tumours are the commonest neuroendocrine neoplasms (NET) with a prevalence of less than one person per 100,000 population. The proliferative index (Ki67%) has a prognostic relevance for pancreatic neuroendocrine tumours, however its value in non-pancreatic NET tumours is unclear. Our retrospective audit was done to look at factors affecting survival. Medical records of 96 patients referred to our clinic since 1999 with a diagnosis of NET tumour (excluding pancreatic primaries) were reviewed in October 2005. 81 patients were alive, 15 were deceased. Analysis of 45 alive and 10 deceased patients, with documented Ki67% was done. Cohort of the alive patients (n=45): 25 (56%) men, mean age at diagnosis 57.6±14.5 years, median survival from diagnosis was 2 years. Tumour sites: foregut 5 (11%), midgut 24 (53%), hindgut 8 (17%), unknown sites 8 (17%). 36 (80%) had metastases at diagnosis (37%-liver, 49% lymph node, 18% in peritoneum, bone, spinal cord.)

Immunohistochemistry: Ki67% of <5 13 (64%) 5–10% −7(16%) and >10 −9 (20%) patients. Management: Surgical resection of primary 24 (53%), long acting somatostatin analogues 17 (38%), interferon 10 (22%), chemotherapy 6 (13%), hepatic embolisation 5 (11%), MIBG therapy in 1 (2%) patient. Cohort of deceased patients (n=10): 8 (80%) men, mean age at diagnosis 62.1±11.5 years and median survival since diagnosis 1.5 yrs. Tumour sites: foregut 2 (20%), midgut 5 (50%), unknown 3 (30%). All patients had metastases at diagnosis (80%-liver, 20%lymph node, 20% ovary, 30% bone, 10% peritoneum and brain). Immunohistochemistry: Ki67% of <5% 4 (40%), 5–10% −2(20%) and >10 −4 (40%) patients. Management: Surgical resection of primary 4 (40%), long acting somatostatin analogues 5 (50%), interferon 6 (60%), hepatic embolisation 2 (20%), chemotherapy 2 (20%), radiotherapy 2 (20%) patients.

Conclusion: A trend (not reaching statistical significance) towards an association between increased age, metastases at diagnosis and Ki67 >5% and poor survival was noted.