NEUROENDOCRINE TUMORS OF THE GASTROINTESTINAL SYSTEM: RESULTS OF THE LAST DECADE markogiannakis@yahoo.com

PW01-08

NEUROENDOCRINE TUMORS OF THE GASTROINTESTINAL SYSTEM: RESULTS OF THE LAST DECADE

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Greece

Oral or Poster

Our aim was to analyze gastrointestinal (GI) tract neuroendocrine tumor (NET) cases operated during the last decade.

Data of all patients operated due to GI NETs are prospectively collected.

Twenty-five cases were included (men:60%, age:60±5.4years). Diagnosis was non-functioning tumor (88%), functioning tumor causing carcinoid syndrome (8%) and gastrinoma (4%). The neoplasm was located in the small bowel in 28%, stomach 24%, appendix 20%, duodenum 12%, esophagus 8% and rectum in 8%. Two appendiceal NET cases had coexistent right colon adenocarcinoma and three recurrent acute appendicitis episodes due to appendix obstruction from the tumor. Two small bowel NETs presented with liver metastases and carcinoid syndrome and one with concurrent right colon adenocarcinoma. Wedge resection was performed in 24%, partial small bowel resection 24%, right hemicolectomy 12%, appendicectomy 12%, total gastrectomy 12%, esophagectomy 8%, partial gastrectomy 4% and low anterior resection in 4%. Mean tumor diameter was 3.4±0.7cm. Tumors were G1 stage in 48%, G2 % 32% and G3 20%. Perineural invasion was identified in 24%, perivascular invasion 20% and lymph vessel infarct 28%. Lymph node dissection was performed in 64% and involvement was identified in 56.2% of the dissection cases (36% of the total population). Chromogranin-A immunohistochemistry was positive in 96%, synaptophysin 92%, NSE 96% and CK8/18 96%. During the short follow-up period of 60.8±5.3months two patients (8%) were reoperated due to recurrence.

Gastrointestinal tract NETs are rare tumors that need a multidisciplinary team approach. Their surgical management is demanding and challenging. A significant share of them may show aggressive characteristics.