A ten-year retrospective analysis of gastroenteropancreatic neuroendocrine tumors (GEP-NETs) in Malaysia

M. Gunavathy, Abdul Ghani Rohana, Norlela Sukor, Nor Azmi Kamaruddin

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Gastroenteropancreatic neuroendocrine tumours (GEP- nETs) are rare neoplasms with a complex spectrum of presentation. The study cohort (n=64) included the diagnoses of carcinoid, (n=26, 41%), insulinoma, (n=25, 39%), undetermined (n=10, 16%), VIPoma, glucagonoma and multiple endocrine neoplasia (MEn-1) (n= 3). Almost half of the patients (n=31) had distant metastasis at diagnosis, the commonest being carcinoid tumours. Presenting symptoms were due to either hormonal expressions or mass effects. diagnoses in all patients were made based on positive immunohistochemical staining for chromogranin and synaptophysin. Less than half (n=30) had either serum chromogranin A, urinary 5-hydroxyindole acetic acid (5-hIAA), serum insulin or C-peptide levels performed. Commonest diagnostic imaging modalities were computed tomography (CT) scan (94%) and abdominal ultrasound (15%). Curative or palliative surgery was performed in 58 patients. Systemic therapy included long acting somatostatin analogues (n=14), chemotherapy (n=7) and interferon-α2b (n=1). nine patients died, all of who had metastatic disease at diagnosis. All patients with insulinoma (n=25) were assessed by endocrinologists whilst carcinoid tumours were mainly managed by surgeons (n=16/26). Involvements of oncologists and gastroenterologists were minimal. This study showed that patients with GEP-nETs in Malaysia commonly presented late in the disease with presence of distant metastases. Less than half had adequate hormonal and biochemical examinations performed for diagnostic as well as prognostic purposes, and only a third received systemic therapy. Lack of institutionalbased database, clinical expertise and multi-disciplinary involvement contributed to the inadequate surveillance and management of the disease.

Original languageEnglish
Pages (from-to)133-137
Number of pages5
JournalMedical Journal of Malaysia
Volume69
Issue number3
Publication statusPublished - 1 Jun 2014

Fingerprint

Malaysia
Carcinoid Tumor
Insulinoma
Vipoma
Glucagonoma
Multiple Endocrine Neoplasia
Neoplasm Metastasis
Chromogranins
Chromogranin A
Synaptophysin
C-Peptide
Diagnostic Imaging
Disease Management
Somatostatin
Serum
Palliative Care
Acetic Acid
Interferons
Gastro-enteropancreatic neuroendocrine tumor
Cohort Studies

Keywords

  • Carcinoid
  • Functional tumours
  • Gastroenteropancreatic tumour (GEP-NETs)
  • Insulinoma
  • Metastasis

ASJC Scopus subject areas

  • Medicine(all)

Cite this

A ten-year retrospective analysis of gastroenteropancreatic neuroendocrine tumors (GEP-NETs) in Malaysia. / Gunavathy, M.; Rohana, Abdul Ghani; Sukor, Norlela; Kamaruddin, Nor Azmi.

In: Medical Journal of Malaysia, Vol. 69, No. 3, 01.06.2014, p. 133-137.

Research output: Contribution to journalArticle

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