Gastro-intestinal tumours recur later than other cancers

The world’s largest study of post-surgical outcomes of particular neuroendocrine tumours has revealed very different recurrence patterns compared to usual cancers.

Led by Monash University’s Director of Oncology Professor Eva Segelov, the collaborative research team published their results in the high impact journal JAMA Oncology this month.

Neuroendocrine tumours (NETs) are a diverse, uncommon group of cancers with increasing incidence and prevalence.  An extremely heterogeneous type of cancer, prognosis of patients with NETs ranges from months in aggressive disease to decades for indolent disease.

Professor Segelov said the study is the largest ever series—by a factor of 10—in reporting outcomes after curative surgery for a rare cancer, Neuroendocrine Tumours (NET), arising from the gut or pancreas,” Professor Segelov said.

“For the first time, our study shows very different recurrence patterns for this kind of tumour.”

“On average NETs take seven to ten years to recur, whereas most other cancers spread to another organ like the liver or lungs within three to five years.”

The significant clinical implications of this study are that these patients need a different follow-up schedule to other cancer patients.

“Instead of having frequent visits and scans in the first few years, these patients should have more intense follow-up after five years—this is quite a paradigm shift,” Professor Segelov said.

Professor Segelov said future research should focus on the cost-effectiveness of surveillance and its impact on patient outcomes.

This work was undertaken using the very large population database of Ontario, Canada, reporting more than 900 cases, and was performed  within CommNETS, an international research collaboration co-founded by Professor Segelov.