Improving Outcomes for Patients with Resectable Small Bowel NET Tumours; Five Year Experience from a Tertiary Centre Abstract #1608

Introduction: There remains controversy about which patients benefit from removal of their primary small bowel tumour and whether this should be performed in a specialist tertiary referral hospital as an elective procedure.
Aim(s): To elucidate important institution specific data
Materials and methods: Retrospective cohort study. Patients were identified from the hospital pathology database having had their primary tumour resected between Jan2011 and Dec2015. Indications for surgery were either symptomatic primary or attempted curative resection. Patients with encased main SMA or SMV were considered unresectable.
Conference: 14th Annual ENETS conference (2017)
Category: Epidemiology/Natural history/Prognosis - Prognosis
Presenting Author: Khalil Elgendy

To read results and conclusion, please login ...

Further abstracts you may be interested in

#18 Long-acting release octreotide induce complete response in type 1 gastric carcinoid tumors
Introduction: Gastric endocrine tumors (GET) are increasingly recognized due to expanding indications of upper gastrointestinal endoscopy. Often silent and benign, GET may also be aggressive when sporadic and may sometimes mimic the course of gastric adenocarcinoma. Current incidence of GETs is estimated at around 8% of digestive endocrine tumors. Yearly age-adjusted incidence is around 0.2 per population of 100,000. Gastric carcinoids (ECLomas) develop from gastric enterochromaffin-like cells (ECL cells) in response to chronically elevated gastrin. Type 1 tumors (ECLomas in the course of atrophic gastritis) may occur in conditions of achlorhydria secondary to auto-immune atrophic fundic gastritis. It occurs mostly in women and they are non-functioning tumors, typically found during upper GI endoscopy performed for dyspepsia. ECLomas present frequently as multiple polyps, usually < 1 cm in diameter in the gastric fundus. Type 1 tumors are almost exclusively benign lesions with little risk of deep invasion of the gastric parietal wall. The neoplastic ECL cells become progressively dedifferentiated with an increasing number of Ki-67 immunoreactive (IR) cell nuclei. In addition, there is a substantial decrease in argynophil and IR NE cells that can be visualized by conventional methods. ECLomas secondary to hypergastrinemia should be closely followed for signs of clinical and histopathological tumor progression. Such ECLomas deserve early, active, radical surgical treatment.
Traditionally, gastric carcinoid type 1 (GCA1s) are endoscopically or surgically removed, depending on the number, appearance and size of the tumors. Antrectomy, with surgical excision of the majority of the G cells, is thought to facilitate regression of these tumors by removing the source of excessive gastrin secretion; however, the long-term benefits of antrectomy still remain uncertain. Although proton pump inhibitors are effective in reducing hypergastrinemia-induced gastric acid hypersecretion in GCA2, they do not affect ECL-cell hyperplasia, and therefore their role in GCA1 is limited. Moreover, in selected cases, significant reduction of hypergastrinemia does not prevent development of ECL carcinoid, suggesting that, in addition to hypergastrinemia, other pathogenic or genetic factors may be involved. Treatment with somatostatin analogues (SSA) might impede ECL-cell hyperplasia by suppressing gastrin secretion and/or by a direct anti-proliferative effect on ECL cells. Treatment with SSAs in GCA1 leads to a substantial tumor load reduction, with a concomitant decrease of serum gastrin levels. Published data indicate an important anti-proliferative effect of SSA on ECL cells, providing clinical benefit and obviating, at least temporarily, the need for invasive therapies for GCA1. Morphometric studies demonstrated that, while antrectomy specifically decreased the volume of ECL cells versus the total volume of endocrine cells, octreotide reduces the overall endocrine cell volume. Although the number of treated patients is small, it has been suggested that SSA may exert important anti-proliferative effects either directly, by inhibiting ECL-cells proliferation, or indirectly through suppression of gastrin hypersecretion.
Conference: 7th Annual ENETS Conference (2010)
Category: Clinical
Presenting Author: MD Ricardo Caponero
#20 Paraneoplastic antigen Ma2 (PNMA2) auto-antibodies as biomarkers for early small intestine neuroendocrine tumors detection
Introduction: Small intestine neuroendocrine tumors (NETs) comprise well-differentiated NET (benign carcinoid), well-differentiated neuroendocrine carcinoma (malignant carcinoid) and poorly differentiated neuroendocrine carcinoma (NEC). The majority of NET patients have developed liver metastases at the time of diagnosis and surgery is then seldom curative. Novel predictive, diagnostic and prognostic markers are thus needed to improve our capabilities to diagnose and cure these tumors. We have previously identified six novel marker genes for neuroendocrine tumor cells by using Affymetrix microarrays and advanced bioinformatics. One of this markers, the paraneoplastic antigen Ma2 (PNMA2), which is normally expressed only in nervous tissue, can in the process of carcinogenesis be detected in tumors located outside the nervous system. The finding that Ma2 is expressed in small intestine neuroendocrine primary tumors and their metastases made it interesting to screen whether antibodies against Ma2 are present in the serum of NET patients.
Conference: 7th Annual ENETS Conference (2010)
Category: Basic
Presenting Author: PhD Valeria Giandomenico
Authors: Cui T, Elgue G, Li S C, Hurtig M, ...
#28 Prognostic Clinicopathologic Factors in Longitudinally Followed Patients with Metastatic Small Bowel Carcinoid
Introduction: Neuroendocrine tumors demonstrate heterogeneous behavior based upon site of origin and specific histology. Even after controlling for anatomic location, disease stage and histologic grade, registry studies show persistent diversity of outcome in patients with midgut carcinoid.
Conference: 7th Annual ENETS Conference (2010)
Category: Clinical
Presenting Author: Mr. Thomas Curran
#30 Diffuse Idiopathic Pulmonary Neuroendocrine Cell Hyperplasia
Introduction: Normal adult lungs contain scattered pulmonary neuroendocrine cells (PNEC). Reactive PNEC hyperplasia is commonly observed in persons who live at high altitude, in cigarette smokers, and in numerous lung diseases. Diffuse Idiopathic Pulmonary Neuroendocrine Cell Hyperplasia (DIPNECH) is a rare entity in which PNEC hyperplasia appears without predisposing conditions. According to the 1999 WHO lung tumor classification, DIPNECH is thought to be primarily a neuroendocrine proliferative process, which can be associated with carcinoid tumors and with a clinical picture of constrictive obliterative bronchiolitis. To date, available data regarding the treatment and the prognosis of this rare condition is limited.
Conference: 7th Annual ENETS Conference (2010)
Category: Clinical
Presenting Author: Dr. Simona Grozinsky-Glasberg
#32 Pancreatic cystic endocrine tumors: a different morphological entity associated with a less aggressive behavior.
Introduction: Cystic pancreatic endocrine tumors (CPETs) are rare lesions and their biological features have been scarcely investigated.
Conference: 7th Annual ENETS Conference (2010)
Category: Clinical
Presenting Author: Dr Massimo Falconi