Surgical management of NET patients remains exceedingly challenging although it continues to provide hope of cure and prolonged survival for some of our patients. Decision making on when to operate is dependent on specialist knowledge and shared expertise of multi-disciplinary NET teams. Surgery may not be appropriate and/or necessary even when there is possibility of a cure. Alternatively, surgery may be necessary to tackle particular issues even when possibility of cure does not exist. Another challenge we face is whether to offer resection of a primary when there are significant distal metastases. There has been substantial improvement in our ability to stage neuroendocrine tumours that is guiding decision making for surgery. Furthermore, clinical trials are being setup to help us improve outcomes with surgery. The 2024 symposium will highlight the challenges and possible solutions.
This meeting is for people making decisions on treatments for patients with NETs. This meeting is important for regional Cancer Alliances, Specialist Commissioners, and the HPB and Colorectal Expert Advisory Groups whose members are often responsible for the initial care of patients with NETs. The delegates will achieve a good understanding of the present role of surgery and the availability of surgical and associated expertise around the UK. The symposium will help develop a national strategy for surgery in patients with NETs.
Invasive multidisciplinary management of GEP NETs: scopes, knives, needles and robots
Tuesday 3rd December 2024, 0900-1600
- Rectal NETs
- Growing incidence and Endoscopic management/follow up
- Implementing ENETS guidelines into NHS practice
- Staging and surgical strategies
- Management of Gastric NETS
- Endoscopic surveillance
- Surgical resection: when/extent of surgery
- SI NETs
- When to operate/when not to
- Surgical technique/indication for minimally invasive surgery
- Trials
- Pancreas
- Indications for surgery
- Role of ablation vs enucleation in PNETs
- Surgical strategy in gastrinoma/MEN-1 and VHL
- Whipple’s – should it ever be performed when liver metastasis present?
- Overall strategy, prognosis and QoL
- Liver metastases
- Is there ever a role for ablation?
- Indications and practicalities of bland/chemo and radioembolisation liver mets
- Surgical strategy for cytoreductive surgery: timing, indications, technique
- Liver transplantation
- Treatment of liver mets to control carcinoid syndrome prior to cardiac surgery
- Clinical trials
- Safe perioperative practices
- Role of NET CNS in management of patients undergoing surgery
- Role of specialist surgery and specialised commissioning of NET services to improve patient outcomes
- MDT session
