AB028. SOH23ABS_110. The role of de-bulking surgery and primary resection in metastatic pancreatic neuroendocrine neoplasms

Background: Pancreatic neuroendocrine tumours (PNETs) are rare, late-presenting tumours with an increasing prevalence worldwide. The aim of this study is to compare the outcomes of patients treated for metastatic PNETs at a single institution. We also report the clinical features and treatment sequence with the aim of identifying a beneficial treatment regime according to tumour histopathological subtype, grade, patient factors, and patient wishes.

Methods: This is a retrospective, anonymized cohort study of all patients who received treatment for PNETs with liver metastases at St Vincent’s University Hospital from 2009 to 2022. Two patient lists were sought from the pathology department to identify positive fine needle aspiration biopsies and positive resections, which would represent the control and treatment group respectively. Patient imaging and co-morbidities were analysed and correlated to outcomes. Data was coded and inputted into an Excel spreadsheet to facilitate statistical analysis.

Results: Of 217 patients, 26 patients met the appropriate inclusion criteria. The results were divided into patient characteristics, disease factors, treatment strategy and patient outcomes in order to compare management strategies. There were 8 medically managed patients and 18 patients who underwent surgical resection. Female patients and those under 65 years had better overall survival. Patients with grade 1 or 2 disease were more likely to achieve a disease-free status or have stable disease.

Conclusions: Resection of primary and metastatic disease in PNETs is a safe and feasible option and offers a viable solution for younger patients with a lower grade of tumour and may render them disease free.

Keywords: Pancreatic; pancreas; neuroendocrine tumour; neoplasm; de-bulking surgery