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Introduction/background: The ENETS network of accredited NET Centres of Excellence (CoE) across Europe was established to standardise and improve NET management. Aims: To compare diagnostic and patient management pathways for lung NET in ENETS CoE with non-accredited UK centres (non-CoE). Materials and methods: Between Oct 2016–May 2017 clinicians at 27 UK centres were interviewed about current patient management. Respondents were from all 10 CoE (4 oncologists, 6 other specialists) and 17 non-CoE (15 oncologists, 2 other specialists). Results are presented as CoE vs non-CoE respondents. Results: Tests and investigations used routinely at diagnosis, include: Pathology, WHO classification (9/10 [90%] vs 12/17 [71%]), Ki-67 index (8/10 [80%] vs 13/17 [76%]); Radiology/Somatostatin Receptor Scintigraphy (SRS), gallium 68 SRS positron emission tomography (PET) (7/10 [70%] vs 3/17 [18%]), FDG PET (9/10 [90%] vs 13/17 [76%]), octreotide SRS (6/10 [60%] vs 12/17 [71%]), bone scan (4/10 [40%] vs 4/17 [24%]); Biochemistry, serum or urine 5-hydroxyindoleacetic acid (8/10 [80%] vs 12/17 [71%]), chromogranin A (10/10 [100%] vs 12/17 [71%]). All 10 CoE and 15/17 (88%) non-CoE respondents had a NET specialist multidisciplinary team meeting (MDTM); 9/10 (90%) vs 7/17 (41%) had a NET clinical nurse specialist; 8/10 (80%) vs 5/17 (29%) had a lung NET patient database. Conclusions: Although based on small numbers, these results suggest that there is wider use of ENETS recommended tests/assessments and greater access to NET nurse specialists and MDTM in CoE compared with non-CoE. This may reflect the rigorous auditing required for ENETS accreditation. Further work is needed to determine whether these apparent differences translate into improved patient outcomes.


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Lung NET, Centre of Excellence, ENETS, treatment pathways, diagnostics