Endocrine Abstracts

Objective: Neuroendocrine tumours (NETs) are rare tumours and require treatment in specialist centres with familiarity management, particularly mitigation of perioperative risk from carcinoid crisis. This study retrospectively analysed the perioperative management of NET focusing on somatostatin analogue (SSA) utilisation. It aimed to evaluate compliance with local and UKINET guidelines and assess adverse outcomes from non-compliance. UKINET guidelines tailor SSA dosing to tumour activity, while local protocols recommend a standard continuous infusion for all.

Methods: A retrospective review of all patients (127) who underwent surgery for G1/2 small bowel NET (SI-NET) between January 2016 and September 2024 at a major tertiary centre. The compliance of SSA administration (intravenous octreotide), was compared to local and UKINET guidelines.

Results: Analysis of 127 patients showed 44.88% (57) to have secretory tumours. While 66.14% (84) of patients received octreotide in line with local trust protocols, only 4.7% (6) were managed in compliance with UKINET guidelines. During post-operative octreotide weaning, 96.8% of patients remained stable, with 3.14% being symptomatic or unstable, although none were formally diagnosed with carcinoid crisis. The data highlights differences in actual practice compared to local and UKINET guidelines with no clearly defined significant adverse events.

Conclusion: The results indicate variation in the use of perioperative octreotide administration with no defined significant adverse outcomes despite little compliance with UKINET guidelines. This study suggests that there is leeway for consideration of an individualised approach to SSA perioperative infusions in terms of timing and duration of administration. Such an approach may prove beneficial in optimising perioperative ward and ITU bed utilisation, reducing costs and maximising patient flow, whilst guarding against perioperative adverse events from carcinoid crisis.