UKINETS2025 23rd National Conference of the UK and Ireland Neuroendocrine Tumour Society 2025 Poster Presentations (33 abstracts)
Late relapse of gastroenteropancreatic neuroendocrine tumours after curative resection: royal marsden experience
Siraphong Putraveephong 1,2 , Ekaterina Ignatova 1 , David Cunningham 1 , Ian Chau 1 , Naureen Starling 1 , Sheela Rao 1 , Derek KT Yeung 1 , Long Jiao 1 , Ricky Bhogal 1 , Daniel Morganstein 1 & Charlotte Fribbens 1
1Royal Marsden Hospital, London, United Kingdom; 2Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
Background: Gastroenteropancreatic neuroendocrine tumours (GEP-NETs) are slow-growing malignancies with rising incidence. Surgery offers the best chance of cure for localised, well-differentiated tumours, but late relapse can occur. Current guidelines recommend surveillance for lifelong, yet evidence supporting extended follow-up is limited, and relapse pattern beyond 5 years remains unclear.
Methods: We retrospectively reviewed patients with localised, well-differentiated GEP-NETs who were diagnosed between 2010 and 2015 and underwent curative resection at Royal Marsden hospital. Clinicopathologic and follow-up data were collected from medical records. Late relapse was defined as recurrence ≥5 years post-surgery. Descriptive statistics were used to summarise baseline characteristics and relapse patterns.
Results: Among 120 patients (median age 56 years, 52% female), primary sites were jejunum/ileum (23%), appendix (22%), pancreas (19%), and other (36%). Most were WHO grade 1–2 (93%) and node-positive (33%). During a median follow-up of 8.0 years, 6 patients (5%) developed late relapse at a median of 7.9 years (range 4.9–10.9). Late relapse was most often observed in patients with small intestinal primaries (83%). Most relapsed tumours were grade 1 (83%) and almost all were stage III at diagnosis (83%). The liver was the most frequent site (67%) relapse. Serum chromogranin A was elevated in 83% of relapsed cases. At the last follow-up, 5 patients were alive with disease, and 1 had died of disease.
| Case | Primary Site | Grade | Stage | Nodal Status | Time to Relapse (yr) | Sites of Relapse | Serum CgA at Relapse | Treatment at Relapse |
| 1 | Ileum | G1 | III | N+ | 5.2 | Liver, node | Normal | SSA |
| 2 | Ileum | G2 | II | N0 | 6.4 | Liver, peritoneum | Elevated | SSA |
| 3 | Duodenum | G1 | III | N+ | 8.8 | Liver, peritoneum | Elevated | SSA |
| 4 | Ileum | G1 | III | N+ | 7.0 | Liver, node | Elevated | Observation |
| 5 | Appendix | G1 | III | N0 | 20.5 | Node | Elevated | SSA |
| 6 | Ileum | G1 | III | N+ | 9.9 | Peritoneum | Elevated | Observation |
Conclusion: Late relapse occurred in approximately 5% of GEP-NET patients after curative resection, most commonly in the liver. These findings support extending surveillance beyond 5 years, particularly for patients with small intestinal primaries. The frequent elevation of serum chromogranin A at relapse supports its use in follow-up strategies.
Volume 114
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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