Endocrine Abstracts

Introduction: Small bowel neuroendocrine tumors (NETs) are rare neoplasms that often present with advanced or metastatic disease. Surgical resection remains the cornerstone of management, either with curative intent or for symptom control. However, real-world outcome data comparing these approaches remain limited.

Methods: We conducted a single center retrospective review of patients who underwent surgical resection for small bowel NETS between 2020 and 2025. A total of 161 patients were included and stratified into 2 groups, those who underwent surgery for curative intent and those operated on for symptom control. All patients underwent a post-operative 68Ga-DOTATATE PET/CT scan within 3 months. All procedures were performed by two colorectal consultant surgeons. Data were collected using institutional informatics and data management systems and analyzed with Excel.

Results: A total of 161 patients were included, with a median age of 65 years (IQR 15), and 59.6% were male. The mean postoperative hospital stay was 9 days. Of these, 95 patients (59%) underwent surgery with curative intent (Group 1), while the remaining 66 underwent non-curative procedures for symptom control (Group 2). In Group 1, 63/95 (66.3%) patients showed no residual or recurrent disease on post-operative 68Ga-DOTATATE PET/CT scan. At last follow-up, 60 remained disease free, while 3 developed recurrence. In this subgroup, the median time to recurrence was 39.4 months with a median disease-free survival (DFS) of 39 months. Among patients in Group 1 with residual/recurrent disease following the operation, 21 had stable disease (median PFS 24.7 months) and 10 developed progressive disease (median PFS 21.4 months). In Group 2, 36/66 (54.5%) patients exhibited progressive disease with a median PFS of 13.6 months, while 30 maintained stable disease with a median PFS of 26.7 months.

Conclusion: Curative surgery for small bowel NETs offers superior disease-free and progression-free outcomes compared with non-curative procedures, underscoring its role as the cornerstone of management whenever feasible. Further prospective studies are needed to validate these findings and identify the risk factors of recurrence/progression.