Samragnyi Madala retweetledi

Thrilled to share our new paper led by Jeremy Chang @UIowa_Surgery and Dr. James Howe! @UIowaCancer @WinshipAtEmory
Peritoneal metastases (PM) in small bowel neuroendocrine tumors (SBNETs) are uniquely challenging; patients face worse oncologic outcomes, and complications such as obstruction which further complicate care.
Our approach:
🔹 Pre-op imaging with DOTA PET/CT + arterial/venous phase CT to map disease and guide surgery
🔹 Disease biology drives decisions — synchronous liver mets don’t exclude surgery
🔹 For G1–G2 well-diff SBNETs → aim for CC-0/1 and >70% cytoreduction
🔹 Even G3 well-diff tumors may benefit from surgical consideration
🔹 If cytoreduction isn’t feasible, palliative surgery or systemic therapy (SSAs, chemo, PRRT*) are options
🔹 Multidisciplinary collaboration is key
PM in SBNETs demands nuanced, individualized, and team-based management — balancing oncologic control, symptom relief, and patient goals.
📖 tinyurl.com/mwhwf5e9
(PRRT may increase bowel obstruction risk)

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