1153P - Evaluation of survival in gastric NEN patients according to tumor characteristic -Polish experience

Date 27 September 2014
Event ESMO 2014
Session Poster Display session
Topics Neuroendocrine Cancers
Presenter Agnieszka Kolasińska-Ćwikła
Citation Annals of Oncology (2014) 25 (suppl_4): iv394-iv405. 10.1093/annonc/mdu345
Authors A.D. Kolasińska-Ćwikła1, A. Lewczuk2, A. Cichocki1, K. Roszkowska1, M. Ćwikła3, J. Ćwikła4
  • 1Department Of Oncology, Maria Sklodowska-Curie Memorial Cancer Center Institiute of Oncology, 00-973 - Warsaw/PL
  • 2Endocrinology, Medical University of Gdansk, 02-210 - Gdansk/PL
  • 3Department Of Gastroenterology, Maria Sklodowska-Curie Memorial Cancer Center Institiute of Oncology, 02-781 - Warsaw/PL
  • 4Faculty Of Medical Science, University of Varmia and Masuria, Olsztyn, 10-561 - Olsztyn/PL

Abstract

Aim

Aim of study was to analyze tumor biology and survival according to tumor subtype and WHO 2010 classification in Polish patients with gastric NEN.

Methods

A data of 87 patients, 55 women and 32 men (mean mean age 54.7 years), with gastric NEN were analyzed. 48 pts (55,2%) had type I gastric NEN, 4 pts (4,6%)- type II and type III-28 pts (32,2%), 7 pts (8%) had MANEC. All had histopathology confirmed diagnosis, also clinical, biochemical and imaging follow-up including hormonal status, and genetic testing in case of MEN-1. All had gastroscopy as initial technique and tumor sampling. Imaging technique performed CT or MRI and SRS-Somatostatin Receptor Scintigraphy, using 99Tc HYNICTOC (Polatom, PL). Management recommendations were issued: endoscopic or surgical treatment of type I and II (including antrectomy to abolish hypergastrinemia) and radical resection with lymph node dissection for type III and IV, or sampling in case of non-resectable tumor. In widespread NEC, patients were treated with chemotherapy platinum based regiments. In case of presence of somatostatin receptor (SST) in SRS, somatostatin analogs therapy and also peptide receptor radionuclide therapy–PRRT 90Y DOTATATE were used for NET.

Results

In type I 42 had pT1/1m disease treated with endoscopy, 2 pts pT2 and one pT3. In type II - 2 of 4 pts had MEN-1 (1 with regional lymph node involvement). In type III pT2-3pts, pT3-8 and pT4-10 pts were reported, 7 pts had pTx due to non-resectable tumour. N1 noted in 75% and 71% had also distant metastases at initial diagnosis. In group with MANEC pT3 = 4 pts, pT4 = 10 pts, 2 had pT2 cancers. Consider WHO 2010 classification: NETG1 53 pts (61%), NETG2-11 pts (13%), NECG3-23 pts (26%) including those with MANEC. Mean Ki-67 in NETG2 tumors was 8.1% and NECG3 56%. There were 50 pts with gastric NETG1 out of those 45 pts with type I, 11 with NETG2, 19 with NECG3, 6 MANETS (all NECG3). In type I there were 2 deaths, not related to tumor. In type II single death in pt with MEN-1. There were 21 deaths in type III gastric NEN (75%) during follow-up. Median OS in type I was N.R, (type II 4 cases), type III 14.5M and in MANEC 20M (P < 0.05 Cox-M). Base on WHO 2010 classification median OS in NETG1 was N.R. in G2 38.5M and G3 12.2M respectively (P < 0.05).

Conclusions

Base of our results there is significant difference in OS according to tumors groups. Type III and NECG3 base on Ki-67 had similar median OS.

Disclosure

All authors have declared no conflicts of interest.