Neuroendocrine tumours (NETs) are rare cancers originating from neuroendocrine cells. The estimated prevalence is 35 per 100,000 people per year. A comparative review was conducted at the University Hospitals of Leicester (UHL) to determine the outcomes of treated neuroendocrine patients.
Methods: Patients were identified via pharmacy records of Lanreotide, from April 2009 March 2018. Clinical data was obtained from hospital notes and histopathology reports were accessed electronically.
Results: During this period, 83 patients were treated. Most patients were Caucasian (87%) and male (57%). The median age at diagnosis was 60 years. At presentation, 86% of patients were symptomatic.The commonest primary site was small bowel (43%) followed by pancreas (25%). Most patients had metastatic disease at presentation (76%), mostly in the liver (86%). Where pathology was available, most tumours were classified as grade 1 (44%). Systemic treatment alone was the most common treatment, occurring in 38% of patients. After 1st line treatment, 86% required a treatment change. All 23 patients who had surgery alone went on to receive 2nd line treatment, with a progression free survival (PFS) of 61.8 months. When starting Lanreotide, the most common dose was 90 mg (51%) with a PFS of 28 months. Patients on 60 mg (21%) had a PFS of 34 months, and those receiving 120 mg (17%) had a PFS of 15 months. The Asian sub-population comprised 6% of patients, and 80% were diagnosed with a grade 2 tumour with liver metastases, and 60% had a Ki-67 index of over 5%. All Asian patients had Lanreotide as part of their primary treatment at 90 mg or above, with a PFS of 19 months.
Discussion: We found that treated NETs were grade 1 tumours, found in Caucasian males, presenting with symptomatic metastatic liver disease. In the smaller population of Asian patients, most NETs were grade 2. The median overall survival regardless of therapy was 59 months, and this fits with a recent review stating this varies from 2468 months.
Conclusion: This study of UHL patients found that the demographics and outcomes of NETs were comparable to those found in recent studies.
10 Dec 2018
UK and Ireland Neuroendocrine Tumour Society