In a patient with pancreatic carcinoid s/p resection with positive margins do you recommend surveillance or adjuvant therapy?
Patient with a well-differentiated neuroendocrine tumor G1 (carcinoid). Copper-64 DOTATATE PET scan demonstrated a pancreatic head mass of 0.8 cm SUV 39 with no mets or LN s/p excision with "robotic-assisted ultrasound-guided enucleation of pancreatic neuroendocrine tumor." Pathology with 0.9 cm low-grade carcinoid, no LVI/PNI, +margin. If no adjuvant therapy, how often would you do surveillance, and which modality?
2 Answers
Mednet Member
Radiation Oncology · Tennessee Oncology
Answered on
Well-diff and by small size (<1 cm), NCCN guidelines would have said watch this from the start, so certainly wouldn't recommend any adjuvant therapy at this time for positive margin resection. Margin status has been shown not to be associated with overall survival outcomes, particularly for low-grad...
Join for free or sign in to see the full answer
Mednet Member
Medical Oncology · Kettering Cancer Care
Answered on
Agree; only surveillance; no proven benefit from adjuvant radiation therapy in low-grade neuroendocrine cancers.
Join for free or sign in to see the full answer