177 The Management of Type 1 Gastric NETs in an eNETS Centre of Excellence

Abstract Aim Glasgow is a designated European Neuroendocrine Tumour Society (eNETS) centre of excellence. The eNETS guidance for small Type 1 gastric NETs (gNETs) suggests either endoscopic surveillance or resection depending upon size or grade. This study assessed adherence to this guidance and whether long-term endoscopic surveillance was maintained and warranted. Method All patients with Type 1 gNETs (Grade 1 or 2) discussed at the West of Scotland NET MDT between 2018 and 2023 were identified from the MDT database. Variables collected included the size, location and differentiation of each and the initial MDT decision and outcome was reviewed. The subgroup of patients undergoing endoscopic surveillance was followed. Results Forty-two patients (median age 67; 18 female) were identified, with MDT outcomes of either endoscopic resection with surveillance or surveillance alone. 5 patients died of other causes. 11 patients had endoscopic resection, 2 with positive margins so underwent surgical resection. 1 patient had recurrence and surgery. Seven patients with Grade 2, well-differentiated lesions were managed with resection (endoscopic or surgical) plus surveillance, with no recurrence or progression observed. The remainder had Grade 1, well differentiated and under managed with endoscopic resection or surveillance; none have progressed or recurred. For both Grade 1 and 2 lesions, the most common protocol was annual endoscopy, averaging 3.5 endoscopies. Conclusions Type 1 gNETS are managed according to eNETS guidance in our unit but we have observed that endoscopic follow up for Type 1, Grade 1, small, well differentiated gNETs may be unnecessary due to the low likelihood of progression.