%0 Journal Article
%T ENETS TNM Staging Predicts Prognosis in Small Bowel Neuroendocrine Tumours
%A Rajaventhan Srirajaskanthan
%A A. Ahmed
%A A. Prachialias
%A P. Srinivasan
%A N. Heaton
%A N. Jervis
%A A. Quaglia
%A G. Vivian
%A J. K. Ramage
%J ISRN Oncology
%D 2013
%R 10.1155/2013/420795
%X Introduction. Small bowel neuroendocrine tumours (NETs) are the most common type of gastrointestinal neuroendocrine tumours. The incidence and prevalence of these tumours are on the rise. The aims of this study were to determine prognostic clinicopathological features and whether the ENETS TNM staging system predicts prognosis and also. Method. Clinical data was collected retrospectively from 138 patients with histologically proven small bowel NETs managed at KingĄ¯s College Hospital. Histology was reviewed and small bowels tumours, were staged according to the ENETS TNM staging system. Results. Median age was 65 years (range 29¨C87). The 5-year survival was 79.5% and the 10-year survival was 48.5%. Resection of the primary tumour was associated with improved survival (120 versus 56 months, ). On multivariate analysis prognostic factors were primary tumour resection and not having a carcinoid heart disease. TNM staging significantly separated survival of stage 2 and stage 3 from stage 4 NETs. Conclusion. Small bowel primary tumour resection and not having carcinoid heart disease are prognostic factors. The ENETS TNM staging and grading system appears to be of prognostic relevance to small bowel NETs. 1. Introduction Neuroendocrine tumours of the small bowel are the most common type of malignant neoplasm in the small intestine, accounting for 35% of small intestinal cancers [1, 2]. Small bowel neuroendocrine tumours (NETs) are the most common type of gastrointestinal neuroendocrine tumours [3]. Small bowel NETs comprise around 38% of gastroenteropancreatic NETs and 21% of all NETs. The incidence and prevalence of these tumours are on the rise, as demonstrated in the Surveillance Epidemiology and End Results (SEER) data and the population-based study in Norway [2, 4]. A threefold increase in incidence has been demonstrated in the USA between 1973 and 2002 [5]. The reported incidence of small bowel NETs is 1/100 000 population [6]. The majority of these tumours do not cause carcinoid syndrome, often presenting late with metastatic disease. Patients with non-hormone secreting tumours often present with vague symptoms, including intermittent abdominal pain or weight loss. A number of patients are identified coincidentally. Approximately 40% of patients with metastatic disease at presentation have functionally active tumours leading to the development of carcinoid syndrome [7¨C10]. Small bowel NETs were generally thought to be indolent tumours; however, their behaviour is more heterogeneous, and consequently a staging and grading system has been introduced by
%U http://www.hindawi.com/journals/isrn.oncology/2013/420795/