Staging of Small Bowel Neuroendocrine

ūüĎČSmall 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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