After R1 resection of a locally advanced, node-positive neuroendocrine tumor of the terminal ilium, would you offer adjuvant radiation therapy?   

For young fit patients, I would consider adjuvant RT for node positive resections. Depending on the grade and Ki-67, I would defer to the med oncs regarding whether they thought there is a role for adjuvant systemic therapy and have a discussion regarding optimal sequencing. There's little prospecti...

Small bowel neuroendocrine tumors have a significant metastatic potential at diagnosis with a 12% nodal, 5% distant metastasis incidence for tumors less than 1 cm, 70% nodal, 19% distant metastasis for tumors >1 cm <2 cm, and 85% nodal, 47% distant metastasis for tumors >2 cm. (Rorstad, PMI...

This is a very nuanced question, and I disagree with those suggesting radiation. The great majority of NETs occur at the terminal ileum and the great majority of these tumors are grade 1 or 2. If there was a positive margin it could take many years for that disease to manifest locally. I think radia...

Obviously, one could do radiation, but I would not. Without clear evidence of OS or even PFS, I would not recommend radiation. I would assume they would have some, potentially much, toxicity from radiation to that area and limited benefit. 

Yes