Staging of Small Bowel Neuroendocrine

Rodrigo Arrangoiz MS, MD, FACS, FSSO

👉Small bowel carcinoids are staged per the American Joint Committee on Cancer (AJCC) Staging Manual (8th Ed.)

  • In addition to AJCC TNM staging, the World Health Organization classification:
    • Divides neuroendocrine tumors into two broad subgroups:
      • Based on grade:
        • Which is determined by:
          • Differentiation
          • Mitotic rate
          • Ki-67 index
  • Well-differentiated tumors include:
    • Low-grade tumors:
      • < 2 mitoses/10 HPF
      • < 3% Ki-67 index
    • Intermediate-grade tumors:
      • 2 to 20 mitoses/10 HPF
      • 3% to 20% Ki-67 index
  • Poorly differentiated neuroendocrine tumors:
    • High-grade tumors:
      • > 20 mitoses/10 HPF
      • > 20% Ki-67 index
        • Resembling small or large cell lung cancer
  • The risk of metastases is high with small bowel carcinoids:
    • 41% present with nodal metastases
    • 16% with distant metastases
  • The risk of metastasis is dependent on:
    • Primary tumor size:
      • But can still occur with tumors less than 1 cm in size

#Arrangoiz #CancerSurgeon #SurgicalOncologist #Surgeon #SmallBowelTumors #Carcinoids

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Published by Rodrigo Arrangoiz MS, MD, FACS, FSSO

My name is Rodrigo Arrangoiz I am a breast surgeon/ thyroid surgeon / parathyroid surgeon / head and neck surgeon / surgical oncologist that works at Center for Advanced Surgical Oncology in Miami, Florida. I was trained as a surgeon at Michigan State University from (2005 to 2010) where I was a chief resident in 2010. My surgical oncology and head and neck training was performed at the Fox Chase Cancer Center in Philadelphia from 2010 to 2012. At the same time I underwent a masters in science (Clinical research for health professionals) at the University of Drexel. Through the International Federation of Head and Neck Societies / Memorial Sloan Kettering Cancer Center I performed a two year head and neck surgery and oncology / endocrine fellowship that ended in 2016. Mi nombre es Rodrigo Arrangoiz, soy cirujano oncólogo / cirujano de tumores de cabeza y cuello / cirujano endocrino que trabaja Center for Advanced Surgical Oncology en Miami, Florida. Fui entrenado como cirujano en Michigan State University (2005 a 2010 ) donde fui jefe de residentes en 2010. Mi formación en oncología quirúrgica y e n tumores de cabeza y cuello se realizó en el Fox Chase Cancer Center en Filadelfia de 2010 a 2012. Al mismo tiempo, me sometí a una maestría en ciencias (investigación clínica para profesionales de la salud) en la Universidad de Drexel. A través de la Federación Internacional de Sociedades de Cabeza y Cuello / Memorial Sloan Kettering Cancer Center realicé una sub especialidad en cirugía de cabeza y cuello / cirugia endocrina de dos años que terminó en 2016.

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