1167P - Neuroendocrine tumors: a review of the Sunnybrook Odette Cancer Centre Database

Date 29 September 2012
Event ESMO Congress 2012
Session Poster presentation I
Topics Neuroendocrine Cancers
Presenter Jeffrey Craig
Authors J. Craig1, M. Cheung2, C. Law3, S. Singh4
  • 1Sunnybrook Odette Cancer Center, M4N 3M5 - Toronto/CA
  • 2Hematology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto/CA
  • 3Surgical Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto/CA
  • 4Medical Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto/CA

Abstract

Background

Neuroendocrine tumors (NETs) are an uncommon and heterogeneous group of malignancies. A number of reviews have been published attempting to better identify factors of important prognostic significance in predicting overall survival, however these studies are often limited by small sample size and were published before new therapy options came into widespread use. AIMS: We reviewed our experience at our NETs multidisciplinary reference centre in the management of NETs to attempt to identify important patient and tumor characteristics associated with improved overall survival.

Methods

The Sunnybrook Odette Cancer Centre NETs Database was retrospectively reviewed. All patients with a pathologically confirmed diagnosis of NET were included in the analysis. Patient characteristics, tumor markers and pathology, treatment, and response to treatment were recorded. Univariate and multivariate Cox-regression analyses were performed.

Results

A total of 327 patients were included in the analysis. Mean age at presentation was 55.6 years. A total of 159 (48.6%) patients were male. The most common primary site was small bowel (34.3%), followed by pancreas (21.1%) and large bowel/rectum/anus (11.9%). In univariate analysis, factors associated with improved overall survival included local/regional disease at presentation (p < 0.001), lower Ki67 index (p < 0.001), normal chromogranin A at presentation (p = 0.008), urinary 5-Hydroxyindoleacetic acid drop following treatment (p = 0.024), symptom response to treatment (p < 0.001), surgery on the primary tumor (p < 0.001), surgery on metastases (p = 0.003), having multiple surgeries (p < 0.001), and treatment with long-acting somatostatin (LAS) (p = 0.029). In multivariate analysis, treatment with LAS (p < 0.001, HR 0.141, 95%CI 0.064-0.31) and having multiple surgeries (p = 0.045, HR 0.591, CI 0.354-0.988) were shown to be independent predictors of improved overall survival.

Conclusions

Treatment with long-acting somatostatin and having multiple surgeries were shown to be independent predictors of improved overall survival in NETs. This data further supports the use of aggressive medical and surgical intervention in a multi-modal approach for advanced NETs. This may be best achieved in the setting of NETs multidisciplinary reference centres.

Disclosure

All authors have declared no conflicts of interest.