ECE2017 Eposter Presentations: Adrenal and Neuroendocrine Tumours Neuroendocrinology (9 abstracts)
Gastroenteropancreatic neuroendocrine tumors (GEP-NETs): clinico-pathological characteristics and disease outcome of 110 patients treated at single referral medical center
Shlomit Koren 1 , Karen Or 1 , Miri Steinschneider 1 , Esther Kummer 1 , Nirit Yarom 2, , Haim Shirin 3, , Ron Lavy 4 , Gratiana Gratiana 5, & Carlos Benbassat 1,
1Department of Endocrinology, Asaf Harofe Medical Center, Zeriffin, Israel; 2Department of Oncology, Asaf Harofe Medical Center, Zeriffin, Israel; 3Department of Gastroenterology, Asaf Harofe Medical Center, Zeriffin, Israel; 4Department of Surgery, Asaf Harofe Medical Center, Zeriffin, Israel; 5Department of Pathology, Asaf Harofe Medical Center, Zeriffin, Israel; 6Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
Introduction: GEP-NETs incidence increased markedly over the past decades probably due to increased imaging. GEP-NETs are generally indolent but often have unpredictable biological behavior and aggressive clinical course.
Aims: To collect information regarding demographics, presentation, pathology characteristics, treatment and outcome of GEP-NETs.
Methods: Following approval of our institutional ethical board, pathology and clinical records of all GEP-NETs patients diagnosed and treated at our institution during 2005–2015 were reviewed.
Results: We identified 110 patients with GEP-NETs distributed by site as pancreatic 32 (F=45.1%, age 61.2±6.8), gastric 19 (F=50%, age 66.2±11), duodenum 9 (F=33.3%, age 66.3±12), small bowel 13 (F=25%, age 60±12), appendix 34 (F=55.8%, age 36±19) and colorectal 3. The pNETs presented with abdominal pain (45.1%) incidentally (25.8%) or syndromatic (21.8%); including two insulinomas, one gastrinoma and four MEN1 patients. Mean size was 31±23 mm and grading was G1 39.2, G2 42.8, G3 17.8%. Distant metastases (DM) were seen in five patients (M1=3). Surgery was performed in 61.3%, additional treatment given to 32.2% (re-op, somatostatin analogue, TKI, chemotherapy). The gNETs presented mostly during work-up for anemia or GI bleeding (70.6%). Mean size was 15 mm and the majority (82.3%) were GCT1 and there were no DM. The dNETs presented with anemia (43%), abdominal pain (43%) or incidentally. None was syndromatic. Mean size was 11.2 mm, 50% were G1, and 2 had DM at presentation. Surgery was performed in 33.3% patients. The sbNETs presented with bowel obstruction (27%), abdominal pain (36%) or incidentally. None were syndromatic. Only 15% were G1, 6 had DM (M1=5), and 77% had surgery. Excluding aNETs, the overall mortality at last visit was 23.7% (7.9% disease related) at mean follow-up of 34.5 months.
Conclusion: GEP-NETs are associated with significant morbidity and mortality. The primary site of the tumor has clinical implication for disease management.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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