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OC-049 Rectal Neuroendocrine Tumours: Management And Survival In 60 Patients
  1. K Naik1,
  2. R Rossi2,
  3. M Caplin1,
  4. C Toumpanakis1
  1. 1Gastroenterology, Royal Free Hospital, London, UK
  2. 2Gastroenterology, Postgraduate School of Gastroenterology, Universita’ Degli Studi Di Milano, Milan, Italy

Abstract

Introduction Rectal neuroendocrine tumours (rNETs) are increasing in incidence, with more found incidentally on routine colonoscopy. Our aim is to retrospectively analyse a cohort of rNETs to characterise diagnostic features and clinical behaviour.

Methods Patients (pts) with confirmed diagnosis of rNET were identified from a database.

Results 60 pts evaluated, median age 55 years (range 23–78). Most common presentation was rectal bleeding n = 29 (48%). 29/60 pts had tumour <1 cm, 7/60 pts 1–2 cm, 22/60 >2 cm, 2/60 size was unknown. Of patients with tumour size <1 cm, 3/29 did not require endoscopic follow-up (pT1a) and of the other 26, none had evidence of recurrence on endoscopic follow-up (follow-up range 6 to 88 m). 24/60 pts had metastases at presentation, 5/60 developed metastases during follow-up (of these 29 pts 86% liver, 40% bone, 10% lung). Of 29 pts with metastases, 24/29 had somatostatin receptor imaging with 62% avid uptake. Chromogranin A available in 23/29 pts: not elevated in 83%. Of 29 pts with metastases, 19/29 had chemotherapy, 10/29 somatostatin analogues (SST), 15/29 surgery and 10/29 peptide-receptor-radionuclide-therapy (PRRT). Chemotherapy: 1/19 pts partial response, 2/19 stable disease (SD), 12/19 progressive disease (PD) (median time to progression 4 months (m)); 4/19 no data. PRRT: 4/10 had SD (follow-up range 24 to 53 m), 4/10 PD (median time to progression 4 m, range 2–9), 2/10 no data. SST: 2 sustained SD (range 12–27 m), 7/10 PD, (median time to progression 3m, range 2–5); 1/10 no data. During median follow-up of 20 m (range 3–170 m), 100% of pts with primary tumour <1 cm, 86% with tumour size 1–2 cm, and 25% with size >2 cm are currently alive. Tumour size >2 cm have poorer outcome than the other 2 groups (p < 0.001).

Conclusion Tumours >2 cm are associated with poor prognosis. Chromogranin A is mostly normal even in advanced disease. Prospective studies are needed to determine progression free survival data for systemic therapy.

Disclosure of Interest None Declared.

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