A single centre audit on the pattern of care of patients with well differentiated neuroendocrine tumours compared to current guidelines — ASN Events
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A single centre audit on the pattern of care of patients with well differentiated neuroendocrine tumours compared to current guidelines (#372)

Shu Fen Lee 1 , Warren Joubert 1 2
  1. Medical Oncology, Princess Alexandra Hospital, Woolloongabba, QLD, Australia
  2. Medical Oncology, Greenslopes Private Hospital, Greenslopes, QLD, Australia

Background: Neuroendocrine tumours (NET) are a group of rare and clinically heterogenous malignancies. Various guidelines have been published in recent years to facilitate a collaborative approach in the diagnosis and management of NET patients.This study aims to review the pattern of care of NET patients at a Brisbane tertiary referral centre and evaluate the level of compliance to current guidelines.

Materials and methods: Patients with well differentiated NET who were reviewed at the Princess Alexandra Hospital (PAH), Brisbane between September 2009 and February 2015 were retrospectively identified from multidisciplinary meeting and pharmacy databases. Clinicopathologic, diagnostic, treatment and follow-up information were collected from medical records.

Results: 61 patients were identified. Median age was 59 years (range 20 to 84 years). Majority of the patients had localised disease at initial diagnosis (n=42). Small bowel was the most common site (34.4%) followed by lung (18.0%) and pancreas (13.1%). 77.0% of patients had upfront surgery while 34.4% went on to have systemic therapy. Only 23.0% and 16.4% of patients had Ki-67 and mitotic index reported, respectively. 85.2% of patients were discussed in a multidisciplinary meeting. 68.9% of patients had ≥2 specialties involved in their care, with either medical oncology or surgery being the predominant specialty. 49.2%, 37.3% and 45.9% of patients had chromogranin A, platelet serotonin and 24 hour urinary 5-HIAA levels measured at baseline, respectively. 13.5% of patients had chromogranin A levels tested too frequently i.e. more than 3 monthly and 53.1% of patients had 24 hour urinary 5-HIAA levels tested too frequently i.e. more than yearly. 31 patients (50.8%) had at least one echocardiogram done with 2 patients developing carcinoid heart disease.

Conclusion: Adherence to recommended standards for the diagnosis and management of NET patients at the PAH could be improved. Consequently, a local hospital-based guideline has been developed to improve quality of care.

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