Introduction: The Birmingham Neuroendocrine Tumour (NET) and Carcinoid Heart Disease( CHD) services evolved into a combined and bespoke specialist service in 2018, with the introduction of the enhanced CHD pathway. This involved discussion at the CHD NET MDT , CHD work-up in the inpatient or outpatient setting and a clinical review in the bespoke CHD NET clinic. The CHD NET pathway is now embedded and well-established at our centre. We have a consistent flow of CHD referrals from all over England, including other ENETS Centres of Excellence. It is well recognized that early diagnosis and referral to an expert, experienced centre is key to improving patient prognosis and outcomes.
Aims: To demonstrate the successes in the CHD NET service and the challenges we face.
Methods: Data was analysed from the NET CNS CHD NET data base and the Trusts Informatic systems.
Results: 69 patients were referred to the CHD MDT between January 2019 and October 2023. 34 patients proceeded with CHD surgery. 19 M and 15 F. Age range 46-79 years: Mean 65.1. 34 patients did not proceed with CHD. 18 M and 17 F. Age range 54-86 years: Mean= 69.2. 1 patient remains under surveillance for potential CHD. The main reasons listed for not proceeding with surgery include frailty, sarcopenia, advanced disease, co-morbidities and considered too high risk.
Conclusion: The enhanced CHD Pathway continues to provide systematic framework that ensures we continue to do the best for this complex group of patients. Future plans include, analysing the outcomes between patients who proceeded with CHD surgery and those who did not proceed with surgery, but remained on medical management.