UKINETS2024 22nd Annual Meeting of the UK and Ireland Neuroendocrine Tumour Society 2024 Poster Presentations (33 abstracts)
Retrospective audit evaluating outcomes in patients post resection for pancreatic neuroendocrine tumours
Christopher Davies 1 , Emily Freeman 1 , Zaira Rehman 2 , Alexander Boyd 2 , Stacey Smith 2 , Mohamad Roji 2 , Mohamed El-Sayed 2 , Simon Hughes 2 , Mona Elshafie 2 , Shishir Shetty 2 , Selva Selvaraj 2 , Salil Karkhanis 2 , Ian Geh 2 , Hema Venkataraman 2 , John Ayuk 2 , Bobby Dasari 2 & Tahir Shah 2
1University of Birmingham, Birmingham, United Kingdom. 2Queen Elizabeth Hospital, Birmingham, United Kingdom
Background: Pancreatic Neuroendocrine tumours (panNETs) are usually sporadic and non-functioning, but occasionally associated with germ-line mutations causing multiple hereditary endocrinopathies. Small, non-functional lesions may be managed conservatively. For panNETs larger than 2 cm the mainstay of treatment is surgery (2). However, postoperative complications are common and can significantly impact patients’ quality of life. The aim of this audit was to explore postoperative outcomes in a cohort of patients who underwent surgical excision of panNETs at an ENETS Centre of Excellence.
Method: Single centre retrospective review for a 5-year period, 2017 till 2022, of patients undergoing surgical resection for panNETs. Data collection was facilitated by informatics and database management tools. Data analysis was performed using Excel.
Results: There were 64 patients in total. Median age 57 (IQR 16.8). 53% were female. 28% were diagnosed incidentally, 20% presenting with symptoms such as diarrhea or of irritable bowel type. 9% had germ-line mutations. 27 (42%) patients had lesions ≤2cm, including gastrinomas or insulinomas. All the resections undertaken were in adherence to the ENETS guidelines (2). The average post-operative hospital length of stay was 8 days. Most common complications were weight loss (48%), diarrhoea (21%), and bile acid malabsorption (11%). Among patients who experienced weight loss, comparing pre-operative to latest follow-up review, the average weight lost was 9.3 kg. Eighty-one percent of the patients started new medications after surgery, with Creon being the most common. Twelve (19%) of the patients had post-op re-occurrence; 7 (56%) individuals with reoccurrence were started on SSA (in combination with surgery/chemotherapy), 2 patients received best supportive care, and 2 patients had further surgery. As of February 2024, 56 patients (89%) were still alive.
Recommendations: This review highlights generally positive patient outcomes, with 89% overall survival rate. Only one patient died within 1 year of the surgery, due to disease progression. However, surgery resulted in significant life-altering changes, particularly weight loss and bowel dysfunction that patients should be counselled about before their treatment. Additionally, there is a need for a study comparing outcomes with and without surgery.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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