A regional cancer center experience of neuroendocrine tumors: clinico-epidemiological profile and treatment outcomes

Background: Neuro Endocrine Tumors (NET) comprises a family of neoplasms derived from the diffuse neuroendocrine system, with a wide range of morphologic, functional and behavioral characteristics. NETs are very uncommon and studies on their clinical profile, management and outcomes are very rare. This study was undertaken to document the clinico-epidemiological profile and outcomes of NETs presenting to a regional cancer centre in South India. Materials and Methods: From a retrospective records review, 252 patients with NET presenting to the Kidwai Memorial Institute of Oncology, Bangalore. The tumor location, clinical symptoms, stage at presentation, sites of metastasis, grading, and modalities of treatment received and their outcomes were studied. Results: The mean age was 53.74 years (± 13.97) (range 19- 85 years) and male: female ratio was 1.6:1. The most common site of presentation was foregut (49.5%), followed by bronchus and lung (17.58%). Among the NETs arising in gastrointestinal tract, esophageal NETs (23.6%) were the most common. Among the oesophageal NETs, nearly 80 % of tumors were located in the lower third of esophagus and gastro-esophageal junction. Metastases seen in 51% of cases, with the majority in liver. Nearly 10% were secretory NETs. Serum Chromogranin levels performed in 10 patients showed a median of 765ng/ml (range 56-2550 ng/ml). Over 70% were classified as poorly differentiated tumors. Nearly 51% received chemotherapy, with 35% receiving cisplatin + etoposide. Almost 15% underwent surgery and 14% received concurrent chemo radiotherapy. Progressive disease was seen in 11% treated cases. The overall survival in the treated cases was 11.25 months for the localized NETs and 4.75 months for the metastatic NETs. Conclusion: NECs occurred more commonly in males and in the foregut, mostly in the lower third of the oesophagus. Metastases were seen in over half the cases, with a large proportion of cases treated with chemotherapy and performed well with intervention.