Behind The Knife: The Surgery Podcast23 Jun 2025

Journal Review in Surgical Oncology: Neuroendocrine Tumors of the Small Bowel

Join the Behind the Knife Surgical Oncology Team as we discuss the two key studies investigating optimal management strategies of neuroendocrine tumors of the small bowel.

Hosts:
- Timothy Vreeland, MD, FACS (@vreelant) is an Assistant Professor of Surgery at the Uniformed Services University of the Health Sciences and Surgical Oncologist at Brooke Army Medical Center
- Daniel Nelson, DO, FACS (@usarmydoc24) is Surgical Oncologist/HPB surgeon at Kaiser LAMC in Los Angeles.
- Connor Chick, MD (@connor_chick) is a 2nd Year Surgical Oncology fellow at Ohio State University.
- Lexy (Alexandra) Adams, MD, MPH (@lexyadams16) is a 1st Year Surgical Oncology fellow at MD Anderson.
- Beth (Elizabeth) Barbera, MD (@elizcarpenter16) is a PGY-6 General Surgery resident at Brooke Army Medical Center

Learning Objectives:
In this episode we review two important papers that discuss optimal management strategies of neuroendocrine tumors (NET) of the small bowel. The first paper by Singh and colleagues discusses the NETTER-2 trial investigating the role of radioligand therapy for NET as a first-line treatment. The second article by Maxwell et all challenges surgical dogma regarding optimal debulking cutoffs for debulking of NET.

Links to Papers Referenced in this Episode:
1. Singh S, Halperin D, Myrehaug S, Herrmann K, Pavel M, Kunz PL, Chasen B, Tafuto S, Lastoria S, Capdevila J, García-Burillo A, Oh DY, Yoo C, Halfdanarson TR, Falk S, Folitar I, Zhang Y, Aimone P, de Herder WW, Ferone D; all the NETTER-2 Trial Investigators. [177Lu]Lu-DOTA-TATE plus long-acting octreotide versus high‑dose long-acting octreotide for the treatment of newly diagnosed, advanced grade 2-3, well-differentiated, gastroenteropancreatic neuroendocrine tumours (NETTER-2): an open-label, randomised, phase 3 study. Lancet. 2024 Jun 29;403(10446):2807-2817. doi: 10.1016/S0140-6736(24)00701-3. Epub 2024 Jun 5. PMID: 38851203. https://pubmed.ncbi.nlm.nih.gov/38851203/

2. Maxwell JE, Sherman SK, O'Dorisio TM, Bellizzi AM, Howe JR. Liver-directed surgery of neuroendocrine metastases: What is the optimal strategy? Surgery. 2016 Jan;159(1):320-33. doi: 10.1016/j.surg.2015.05.040. Epub 2015 Oct 9. PMID: 26454679; PMCID: PMC4688152. https://pubmed.ncbi.nlm.nih.gov/26454679/

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