Endocrine Abstracts

Background: NETs are rare tumours arising from dispersed neuroendocrine system. Nevertheless, their estimated prevalence increased lately, mostly due to progress in imaging, biochemical and histopathological diagnostics.

The aim of the study was to present the characteristics of the NETs patient surveyed in our Endocrinology Department since 2000.

Material and methods: One hundred and fifty-eight patients (males – 42.4%, females – 57.6%) aged 18–82 years were included in the analysis. Medullary thyroid cancer, small cell lung cancer and pheochromocytoma patients were excluded.

Results: According to WHO NETs classification patient in stage Ia constituted 2.5%, Ib-38.6%, II-57%, III-1.3%, IV-0.6% of the analyzed group. The most common localization of the primary tumour was pancreas (34.2%). About 18.4% of studied NETs arose from foregut, 25.3% from midgut (including 5% tumours from appendix) and 17.1% from hingut. Five percent of disseminated NETs had unknown primary origin. Among the NETs there were such rare as epiglottis and gallbladder carcinoids. Distant metastases were found in 29% of the patients, which may be attributed to the relatively high proportion of indolent gastric NETs, insulinomas, and early diagnosed rectal carcinoids. Functioning NETs constituted 41.1% of the group. About 77.2% of the patients were treated surgically, 9.5% received systemic chemotherapy, 19.6% – radioactive peptide therapy. About 5.1% of the study group died – most often due to complications of ectopic Cushing’s syndrome.

Conclusions: Modern and widely accessible diagnostic procedures (particularly endoscopy and endoscopic surgery) result in increased number of early recognized NETs. It implies the possibility of radical surgical treatment, although due to indolent behavior of NETs all patient should be periodically screen for distant metastases. Relatively low mortality among NETs patient, even with disseminated disease, may be attributed not only to the tumour biology, but also to the new methods of treatment (particularly radiopeptide therapy), which are able to stabilize the disease and offer control of its symptoms.