Aims: We aim to examine the clinico-pathological characteristics of neuroendocrine tumours (NET) in Northern Territory (NT) and identify the management outcomes, mortality and progression free survival (PFS) of these patients (pts).
Methods: This is a retrospective casenotes audit of pts diagnosed with NET in NT from July 2004-July 2014. Included pts have received treatment (tx) in Royal Darwin Hospital. Pts lists and baseline characteristics were collected from pathology and pharmacy protocol databases. Descriptive analyses were performed.
Results: A total of 41 non-Indigenous pts were identified; 20 were males and 36 pts were evaluable for tx response. Median age was 57 years (range 16-93).Ninety-five percent (n=39) had ECOG 0-1 performance status while 66% (n=27) had >1 comorbidities. Sixty-three percent (n=27) had localized disease at the time of diagnosis and gastrointestinal tract was the major primary site (63%), with 22% in the appendix. Grade, mitotic rate and biomarkers were not routinely measured for all pts. Abdominal pain (n=21), bleeding (n=9) and diarrhoea (n=4) were the most common presenting symptoms. None had carcinoid cardiac disease. The mean time from symptoms to diagnosis was 5 months and 6 months from diagnosis to tx. Major sites of metastases were the liver (n=11), lymph node (n=8), bone (n=6), and mesentery (n=3). Disease control rate was 74% (59% had surgery). Median PFS was 20 months, with >60% survival at 3 years. Pts with metastatic, inoperable or recurrent disease received somatostatin analogue and was continued beyond progression.
Conclusion: This is the first study to analyse the characteristics of NET in NT. Tumour heterogeneity, diverse terminology and classification as well as variation in histological reporting are known clinico-pathological challenges. Despite symptoms, pts present late with subsequent delays in diagnosis and tx. Whether avoiding these delays translates to better survival outcomes is still unknown and warrants a prospective evaluation.