Endocrine Abstracts

Introduction: The ileum and jejunum represent one of the commonest sites of neuroendocrine tumours (NET), around 15% of all NET in the UK. Around half of NETs at these sites have localised disease (stage 1-3) at diagnosis thus being candidates for curative resection. The European Neuroendocrine Tumour Society (ENETS) guidance on surveillance post resection of SI NET, recommend prolonged, and relatively intensive, imaging investigations, particularly within 5 years post-surgery. Analysis of retrospective data to determine patterns of relapse after SI NET resection might inform further development of follow-up schedules.

Methods: The West Yorkshire NET service regional MDT database was analysed for patients reviewed after resection of ileal and jejunal NET - January 2011 to December 2019. Electronic patient records were examined to determine patient and tumour characteristics and results of radiological and biochemical follow up investigations. Hospital and GP records were used to determine overall survival, patients remaining alive censored as of the date of last clinical appointment.

Results: 83 patients were deemed eligible for analysis with 79 evaluable for relapse. Median patient age was 66 years (range 22-87) with 33% being 70 or older. AJCC tumour staging was: 12% stage 2; 88% stage 3. Tumour grade (ENETS/WHO): 1 = 67%; 2 = 29%; 3 = 4% 29 (37%) patients relapsed with 50 (63%) showing no relapse during follow up. 20 patients (24%) died during follow up, 6 patients of recurrent NET, 5 of other cancers. The median overall survival from date of surgery was 107 months (IQR = 73m – 135m). 5 year and 10 year relapse free survival was 64% and 44% respectively with overall survival at 5 year 84% and 10 year 69%.

Discussion: This retrospective analysis, with a variety of follow up schedules, shows that in a real world cohort of patients 66% did not relapse post resection and of those relapsing this was after 3 years in more than 50%. Review of factors potentially associated with early relapse or prolonged survival post relapse will be presented to determine their usefulness in further individualising follow-up.