Single institutional series of neuroendocrine tumors managed in the Australian Capital Territory

Abstract

Aims: Retrospective review of neuroendocrine tumors (NETs) treated within the Australian Capital Territory to describe the local epidemiology and assess prognostic clinicopathological factors.

Methods: Patients with histologically proven non-pulmonary low to intermediate grade NETs were identified from our hospital clinical database. Data were analyzed according to epidemiological, clinical and histopathological characteristics.

Results: Of the 107 included patients, the most common primary tumor site was jejunum/ileum (32%), followed by rectum (22%) and pancreas (11.2%). In total, 32% had distant metastases at presentation, most commonly in the liver. Most patients were symptomatic at diagnosis, while 22.4% of cases were found incidentally. Second malignancies, in particular of gastrointestinal origin, were diagnosed in 33.6%. Surgical debulking was the most common treatment (59.8%) while 18% had multimodality therapy. With a median follow-up of 25 months from diagnosis, about 78% of patients are still alive. Median time to first relapse was 15 months and the 5-year survival rate was 80% for NETs of jejunum/ileum. Univariate survival analysis revealed tumor location, high Ki67 index, raised plasma chromogranin A, and urine 5-hydroxyindoleacetic acid upon diagnosis to be associated with shorter 5-year survival.

Conclusion: The epidemiologic characteristics and long-term outcome in our series are comparable to other reported studies. This analysis presents some important prognostic factors which could be used for risk stratification in patients with NETs.

Keywords: chromogranin A; epidemiology; neuroendocrine tumors; prognostic factors; survival.