Endocrine Abstracts

Introduction/ Background: Typical (TC) and atypical carcinoids (AC) are the most common neuroendocrine tumors (NETs) of the lung. Being a rare disease, the management of these tumors varies widely among Swiss centers. The impact of guidelines introduced in 2015 is unknown.

Aims: Comparison of the management of Swiss patients before and after the publication of the expert consensus of the European Neuroendocrine Tumor Society (ENETS) in 2015.

Material and Methods: Retrospective analysis of patients with TC and AC using data from the Swiss NET registry from 2009 to 2021, focusing on diagnostic evaluation and treatment before and after 2016. Survival analysis was performed using the Kaplan Meier method and log-rank test.

Results: Overall 238 patients were included, thereof 75,6% (180) with TC and 24,4% (58) with AC, with 155 patients included before and 83 patients after 2016. An increase in the use of functional imaging was observed, 10,3% (16) before and 22,8% (19) after 2016 respectively, P<0,001. In histopathological evaluation, the presence of SST2A-receptors was determined more often; 14,8% (23 times) before 2016 and 26,5% (22 times) after, P<0,001. Concerning the therapeutic approach, higher removal of lymph nodes after 2016 was observed, 53,5% (83) before compared to 78,3% (65) after, P<0,001. No difference in mortality was seen before and after 2016. Generally, median overall survival for patients with AC was significantly shorter with 89,5 months compared to 156,9 months for patients with TC, P<0,001.

Conclusions: The ENETS guideline recommendations have ameliorated the management of TC and AC, however there is still room for further standardization and improvement.