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Cancer Innovation 2022, 1(4): 305-315 https://doi.org/10.1002/cai2.41
Original Article | Open Access | Issue | Published: 16 December 2022

Evaluation of quality of clinical management of neuroendocrine tumors

Show Author's Information Hannah Bloemen1,  Kristien Kneepkens1,  Karen Deraedt2,  Anna Ivanova1,  Gregory Sergeant1,3,  Jeroen Mebis1,4,  Kurt Van der Speeten1,5( )
Department of Medicine, Faculty of Medicine and Life Sciences (LCRC), Hasselt University, Diepenbeek, Belgium
Department of Pathology and Department Future Health, Ziekenhuis Oost‐Limburg, Genk, Belgium
Department of Abdominal Surgery and Department Jessa & Science, Jessa Hospital, Hasselt, Belgium
Department of Medical Oncology and Department Jessa & Science, Jessa Hospital, Hasselt, Belgium
Department of Surgical Oncology and Department Future Health, Ziekenhuis Oost‐Limburg, Genk, Belgium
Keywords:
guidelines, quality, epidemiology, overall survival, neuroendocrine tumors, pathology report, Ki67
Cite this article:
Bloemen H, Kneepkens K, Deraedt K, et al. Evaluation of quality of clinical management of neuroendocrine tumors. Cancer Innovation, 2022, 1(4): 305-315. https://doi.org/10.1002/cai2.41
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Abstract Full text About this article
Background

Neuroendocrine tumors (NETs) are a group of biologically and clinically heterogeneous neoplasms predominantly found in the gastrointestinal and bronchopulmonary tractus. Despite a rising incidence, implementation of evidence‐based standardized care for this heterogenous group remains challenging. The European Neuroendocrine Tumor Society regularly reviews guidelines regarding diagnostic and treatment strategies for NETs. The aim of this study is to shed light on the care of patients with a NET in Belgian Limburg, to provide data as a basis for future studies and to check whether data and results are according to consensus guidelines and outcomes described in literature.

Methods

Our study concerned a detailed observational data collection of two large Belgian hospitals (Jessa Hospital Hasselt and Hospital Oost‐Limburg Genk) with special interest in patient profile, quality of pathology reports, use of diagnostic imaging, and overall survival. Data on 188 patients were assembled between January 2010 and December 2014 with follow‐up until June 2016 (median follow‐up: 33.6 months).

Results

Fifty percent of patients were male. NETs were located mainly in the digestive tract (63.8%) and lung (20.2%). Appendiceal NETs were diagnosed at a significantly younger age than other tumors (41.3 vs. 64.0 years). Overall, a mean pathology report quality score of 3.0/5 was observed with the highest scores for small bowel NETs. Diagnostic and nuclear imaging was performed in 74.5% and 29.8% of cases, respectively. Seventy‐four percent of the population survived until the end of the observation period with highest survival rates for appendiceal and small bowel NETs.

Conclusion

Overall, epidemiological results were comparable with findings in the literature. Gastrointestinal NETs met most of the requirements of qualitative pathology reporting and diagnostic imaging as listed in the European Neuroendocrine Tumor Society consensus guidelines. However, consensus with regard to bronchopulmonary NETs is still scarce and remains an objective for future research. Moreover, discussing treatment strategies in specialized multidisciplinary tumor boards would facilitate regional care.


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Abstract
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About this article

Evaluation of quality of clinical management of neuroendocrine tumors

Show Author's information Hannah Bloemen1, Kristien Kneepkens1, Karen Deraedt2, Anna Ivanova1, Gregory Sergeant1,3, Jeroen Mebis1,4, Kurt Van der Speeten1,5( )
Department of Medicine, Faculty of Medicine and Life Sciences (LCRC), Hasselt University, Diepenbeek, Belgium
Department of Pathology and Department Future Health, Ziekenhuis Oost‐Limburg, Genk, Belgium
Department of Abdominal Surgery and Department Jessa & Science, Jessa Hospital, Hasselt, Belgium
Department of Medical Oncology and Department Jessa & Science, Jessa Hospital, Hasselt, Belgium
Department of Surgical Oncology and Department Future Health, Ziekenhuis Oost‐Limburg, Genk, Belgium

Abstract

Background

Neuroendocrine tumors (NETs) are a group of biologically and clinically heterogeneous neoplasms predominantly found in the gastrointestinal and bronchopulmonary tractus. Despite a rising incidence, implementation of evidence‐based standardized care for this heterogenous group remains challenging. The European Neuroendocrine Tumor Society regularly reviews guidelines regarding diagnostic and treatment strategies for NETs. The aim of this study is to shed light on the care of patients with a NET in Belgian Limburg, to provide data as a basis for future studies and to check whether data and results are according to consensus guidelines and outcomes described in literature.

Methods

Our study concerned a detailed observational data collection of two large Belgian hospitals (Jessa Hospital Hasselt and Hospital Oost‐Limburg Genk) with special interest in patient profile, quality of pathology reports, use of diagnostic imaging, and overall survival. Data on 188 patients were assembled between January 2010 and December 2014 with follow‐up until June 2016 (median follow‐up: 33.6 months).

Results

Fifty percent of patients were male. NETs were located mainly in the digestive tract (63.8%) and lung (20.2%). Appendiceal NETs were diagnosed at a significantly younger age than other tumors (41.3 vs. 64.0 years). Overall, a mean pathology report quality score of 3.0/5 was observed with the highest scores for small bowel NETs. Diagnostic and nuclear imaging was performed in 74.5% and 29.8% of cases, respectively. Seventy‐four percent of the population survived until the end of the observation period with highest survival rates for appendiceal and small bowel NETs.

Conclusion

Overall, epidemiological results were comparable with findings in the literature. Gastrointestinal NETs met most of the requirements of qualitative pathology reporting and diagnostic imaging as listed in the European Neuroendocrine Tumor Society consensus guidelines. However, consensus with regard to bronchopulmonary NETs is still scarce and remains an objective for future research. Moreover, discussing treatment strategies in specialized multidisciplinary tumor boards would facilitate regional care.

Keywords: guidelines, quality, epidemiology, overall survival, neuroendocrine tumors, pathology report, Ki67

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Publication history
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Publication history

Received: 05 September 2022
Accepted: 18 November 2022
Published: 16 December 2022
Issue date: December 2022

Copyright

© 2022 The Authors.

Acknowledgements

This study was designed and conducted by the Limburg Clinical Research Center (LCRC), a collaboration between Hasselt University, Jessa Hospital (Jessa) and Hospital Oost‐Limburg (ZOL). We thank Helene Piccard for the coordination of the study.

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This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial‐NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.

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