173 The Management of Upper GI Neuroendocrine Neoplasms in an eNETs Centre of Excellence

Abstract Aim Glasgow is designated as a European Neuroendocrine Tumour Society Centre of Excellence. This study is a retrospective 5-year review of outcomes of all oesophageal, gastric and duodenal Neuroendocrine Neoplasms comparing our practice to eNET guidelines. Method Patients with UGI NETs discussed in the West of Scotland NET MDT from 2018-2023 were identified. Patient records were reviewed identifying site of lesion, grade, size, single or multiple, staging investigations and MDT outcomes. Outcomes included endoscopic surveillance, endoscopic resection, surgical resection, discharge and palliation. Results 118 patients included, median age 69, 36 women. 34 duodenal, 15 oesophageal, and 69 gastric lesions. All Grade 3 Neuroendocrine Carcinomas, including all oesophageal lesions, had MDT outcomes of palliation due to fitness or metastatic disease at presentation. Grades 1 and 2 stomach and duodenal lesions were well differentiated, 20mm or smaller. Duodenal lesions were single. Most gastric lesions were in the body; 17 patients had multiple lesions. Grade 1 and 2 gastric or duodenal lesions - those suitable for endoscopic resection underwent resection and surveillance, and those unsuitable had surveillance only, with no progression in any group. Seven patients with grade 1 or 2 gastric or duodenal lesions had surgical resection with no recurrence. Staging investigations (EUS, Tektroyd and CT CAP) were appropriately requested as per eNET guidelines. Conclusions The outcomes from grade 3 NECs have been poor due to advanced disease at presentation. Outcomes for grade 1 and 2 gastro-duodenal lesions comply with the eNET guidelines.