PTU-026 Surgical management of duodenal neuroendocrine tumours

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Abstract

Introduction

Duodenal neuroendocrine tumours (D-NETs) are rare tumours. The management of D-NETs is complex due to the lack of understanding of the natural course of disease. We present a single centre experience in the surgical management of these tumours with long term follow up.

Methods

Retrospective single arm observational study of D-NETs treated at our institution between January 2010 until August 2017.

Results

Twenty four patients (13 male), with a mean age of 60.33±13.6 were treated for D-NETs during the study period. The patients either underwent pancreaticoduodenectomy (7 patients-29.2%), segmental duodenal resection (7 patients-29.2%) or Endoscopic Mucosal Resection (10 patients-41.7%). The mean overall survival was 96.08±3.82 months (95% CI: 88.58–103.58); 6 patients presented recurrence at 23.41±8.65 months. There was no statistical significant difference in either disease free survival (Mantel-Cox Log Rank p=0.327) or overall survival (Mantel-Cox Log Rank p=0.317) between patients undergoing each type of resection. Among patients who underwent surgical resection (pancreaticoduodenectomy or segmental resection) we were unable to correlate the size of the tumour with presence of nodal disease at the time of resection. Among those patients who presented with metastatic liver lesions, those were of the same or lower grade compared to primary tumour.

Conclusions

Formal oncological surgical resection should be considered in patients with locally advanced disease if patients are fit and wish to undergo surgery. In patients with localised disease (pT1) endoscopic resection can be considered with evidence of good long term survival.

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