Clinical – Surgery/Applied Pathology | 0089 | NANETS2022 | NANETS 2022

ea0089c30 | Clinical – Surgery/Applied Pathology | NANETS2022

Liver-Directed Therapy of Neuroendocrine Liver Metastases

Meloche-Dumas Leamarie , Mercier Frederic , Barabash Victoria , Law Calvin , Coburn Natalie , Singh Simron , Myrehaug Sten , Chan Wing , Hallet Julie

Background: The optimal therapy sequencing for metastatic neuroendocrine tumors (NETs) remains undefined. Recent advances in systemic therapies may have changed approaches. Better understanding in patterns of care is necessary to assess and design treatment strategies. We examined the use of factors associated with liver-directed therapy over time.Methods: We conducted a population-based study of metastatic NETs over 2000-2019. Outcomes were use of liver...

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ea0089c31 | Clinical – Surgery/Applied Pathology | NANETS2022

Goblet Cell Adenocarcinoma (GCA) of the Appendix: Interrogating Proteomics to Identify Potential Actionable Targets

Patel, MBBS, MD Krutika , Du, PhD Liping , Revetta, PhD Frank , Kay Washington, MD, PhD Mary , Berlin, MD Jordan , Das, MD, MSCI Satya

Background: Appendiceal GCA is a tumor which has been misunderstood for decades. GCAs are comprised of goblet-like mucinous cells, with variable numbers of neuroendocrine and Paneth-like cells and lie on the spectrum between appendiceal adenocarcinoma and neuroendocrine tumors. Prognosis depends on the stage and tumor grade; 30% of patients with low-grade and 50-70% of high grade GCAs present with metastatic disease. Currently, there are limited systemic therapy options and de...

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ea0089c32 | Clinical – Surgery/Applied Pathology | NANETS2022

Surgical Management of G3 Gastroenteropancreatic Neuroendocrine Neoplasms: A Systematic Review and Meta-Analysis

Ziogas, MD, MPH Ioannis A. , T. Tasoudis, MD Panagiotis , C. Borbon, MD Luis , K. Sherman, MD, FACS Scott , J. Breheny, MS, PhD Patrick , Chandrasekharan, MBBS Chandrikha , S. Dillon, MD Joseph , M. Bellizzi, MD Andrew , R. Howe, MD, FACS James

Background: Grade 3 (G3) gastroenteropancreatic (GEP) neuroendocrine neoplasms (NENs) are rare, aggressive tumors with poor prognosis. The WHO 2017 classification further subdivided G3 NENs into G3 neuroendocrine tumors (NETs) and neuroendocrine carcinomas (NECs). Current guidelines favor medical management in most of these patients, and the role of surgical management is not well-defined. We performed a systematic literature review and meta-analysis of surgical management vs ...

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ea0089c33 | Clinical – Surgery/Applied Pathology | NANETS2022

High-Grade Pancreatic Neuroendocrine Neoplasms: Interobserver Diagnostic Accuracy and Relationship with Clinicopathological and Molecular Characteristics

Taherian, MD Mehran , Waters, MD Rebecca , Foo, MD Wai Chin , Maru, MD Dipen , Abraham, MD Susan C. , Rashid, MBBS, PhD Asif , Wang, MD, PhD Huamin , Wei, MD Dongguang , Taggart, MD Melissa W. , Chatterjee, MD Deyali

Background: The pathogenesis, biologic behavior, and treatment of well-differentiated neuroendocrine tumors (NET) and poorly differentiated neuroendocrine carcinomas (NEC) are different. The diagnosis relies on multiple factors, but pathologic assessment is crucial. Based on currently available diagnostic criteria, the distinction between NET G3 and NEC are made on morphologic assessment, without taking Ki-67 proliferative index into consideration. This study looks at the conc...

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ea0089c34 | Clinical – Surgery/Applied Pathology | NANETS2022

Grade Creep and the Importance of Tissue Sampling: Changes in Ki-67 and Grade in Serial Neuroendocrine Tumor Samples

Byun Suzie , M. DePietro Daniel , Ackerman Daniel , P. Gade Terence , C. Soulen Michael

Background: Neuroendocrine tumor (NET) grade, which utilizes Ki-67 expression, is a useful prognostic tool and aids in treatment decisions. However, it is not well known how these measures evolve over time. This retrospective review evaluates changes in Ki-67 and grade over time in patients with multiple NET tissue samples.Methods: 77 patients were included (44M; mean age 58&pm;9.5 years at first sample). Primary NET sites included 46 small bowel, 21 pan...

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ea0089c35 | Clinical – Surgery/Applied Pathology | NANETS2022

Liver Directed Therapy is Associated with Improved Survival in Metastatic Gastroenteropancreatic Neuroendocrine Neoplasms with Concurrent Bone Metastasis

Limbach, MD Kristen E. , Mahuron, MD Kelly M. , Ituarte, PhD Philip H. G. , Kessler, MD Jonathan , Li, MD Daneng , Singh, MD Gagandeep

Background: Bone metastasis from gastroenteropancreatic neuroendocrine neoplasms (GEP-NENs) was once considered rare, but prevalence has recently been reported as high as 12%. Although bone metastasis has been associated with poor prognosis, the most frequent cause of mortality in this population remains liver failure when liver metastases are present. Thus, it remains unclear whether patients with concurrent liver and bone metastasis who receive liver directed therapy (LDT) w...

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ea0089c37 | Clinical – Surgery/Applied Pathology | NANETS2022

Is There a Role for Surgical Resection of Grade 3 Neuroendocrine Neoplasms?

C. Borbon, MD Luis , G. Tran, MD Catherine , K. Sherman, MD Scott , Hien Ear, PhD Po , Chandrasekharan, MD Chandrikha , M. Bellizzi, MD Andrew , S. Dillon, MD Joseph , M. O'Dorisio, MD Thomas , R. Howe, MD James

Background: Grade 3 (G3) gastroenteropancreatic (GEP) neuroendocrine neoplasms (NENs) are aggressive tumors with poor survival outcomes for which medical management is usually recommended. This study sought to evaluate outcomes of surgically treated G3 GEP-NEN patients.Methods: A single-institutional prospective NEN database was reviewed. Patients with G3 GEP-NENs based on World Health Organization (WHO) 2019 definitions included well-differentiated neur...

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ea0089c38 | Clinical – Surgery/Applied Pathology | NANETS2022

Increased Incidence, Prevalence, and Surgical Management of Enteropancreatic Neuroendocrine Tumors Is Associated with Improvements in Survival - A Contemporary Analysis

Concors, MD Seth J , Tzeng, MD Ching-Wei D , Ikoma MD Naruhiko , Kim MD Michael , Cao, MD Hop Tran , Lee, MD Jeffery E , Katz, MD Matthew HG , Maxwell, MD, MBA Jessica E

Background: Neuroendocrine tumors (NETs) are increasing in incidence and prevalence. Small intestine, rectum, pancreas and appendix are the most common enteric sites of NETs, and when identified early, surgical resection can be curative. We hypothesized that observed increases in incidence and prevalence of NETs are primarily driven by earlier detection of loco-regional tumors. In turn, increases in incidence of early-stage tumors is associated with increases in resection and ...

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ea0089c39 | Clinical – Surgery/Applied Pathology | NANETS2022

Have We Accounted for Asians? A Critical Analysis of Racial Cancer Disparity Amongst Asian Pancreatic Neuroendocrine Tumor Patients

E McElroy, MD Katherine , Irfan, MD Ahmer , Reddy, MD Sushanth , Yates, PhD Clayton , Chen, MD, FACS Herbert , Bart Rose, MD J.

Background: Pancreatic neuroendocrine tumors (pNETs) are slow growing, malignant tumors that show different survival outcomes by race. They are often diagnosed in late stages, with few treatments available. PNETs are the second most common pancreatic cancer and are rapidly increasing in incidence. Current size-based guidelines were largely developed in White patients and recently have been called into question for Black patients. We investigated differences of primary tumor si...

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ea0089c40 | Clinical – Surgery/Applied Pathology | NANETS2022

TP53 Mutation Portends a Worse Overall Survival in Patients with Advanced Grade 3 Well-Differentiated Neuroendocrine Tumors

Joseph Nancy , Paciorek Alan , Khuong Le Bryan , Moon Farhana , Zhang Li , Bergsland Emily

Background: The well-differentiated grade 3 neuroendocrine tumor (G3NET) category was introduced in the 2017 WHO classification as a new category of high-grade neuroendocrine neoplasm (NEN). G3NET is thought to have worse overall survival (OS) than lower grade NET, but better OS than poorly differentiated neuroendocrine carcinoma (NEC). However, challenges in pathologic diagnosis and changes in terminology have limited our understanding of the G3NET category. We compared outco...

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ea0089c41 | Clinical – Surgery/Applied Pathology | NANETS2022

SSTR-2 Expression in Solid Tumors: An Immunohistochemistry Analysis

Chauhan Aman , Arnold Susanne , Bocklage Therese , Yan Donglin , Li Ning , Anthony Lowell , Allison Derek

Background: Somatostatin receptor (SSTR) expression has been characterized in well-differentiated neuroendocrine tumors (NET). However, the understanding of receptor expression in various non-neuroendocrine solid tumors is limited. This study was performed to evaluate SSTR-2 in various cancers to provide a rational basis for SSTR-2 targeted anti-cancer therapies.Methods: Formalin-fixed paraffin, paraffin-embedded tissue was obtained from pathology archiv...

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ea0089c42 | Clinical – Surgery/Applied Pathology | NANETS2022

Small Intestinal NET Recurrence – When Why and How?

Pai Priya K. , Gudmundsdottir Hallbera , Cleary Sean P. , Halfdanarson Thorvardur R.

Background: Through this study, we hoped to better understand the factors affecting recurrence-free survival in patients who have undergone curative intent resection for small bowel neuroendocrine tumors (SB-NETs). Extensive literature exists on recurrence predictors for pancreatic NETs but not for those of the small bowel. We hope to bridge this gap.Methods: We retrospectively evaluated patients who had received their index curative-intent operation for...

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ea0089c43 | Clinical – Surgery/Applied Pathology | NANETS2022

Post-Operative Biochemical Surveillance Thresholds Can be Used to Monitor for Sympathetic Pheochromocytoma/Paraganglioma Recurrence and Metastasis

S Lui Michael , B Fisher Sarah , G Grubbs Elizabeth , D Perrier Nancy , G Waguespack Steven , Varghese Jeena , A Habra Mouhammed , Jimenez Camilo , H Graham Paul

Background: Sympathetic pheochromocytomas and paragangliomas (PPGLs) are rare neuroendocrine tumors associated with excess catecholamine production. Routine biochemical and imaging surveillance to monitor for recurrence and metastasis is recommended. However, there is limited data describing optimal surveillance approaches and post-operative biochemical thresholds for detecting recurrences or metastases. This study sought to correlate biochemical and imaging surveillance with ...

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Endocrine Abstracts

NANETS 2022

15th Annual Multidisciplinary NET Medical Symposium NANETS 2022