ENETS Consensus Guidelines for the Management of Patients with Digestive Neuroendocrine Neoplasms of the Digestive System: Well-Differentiated Pancreatic Non-Functioning Tumors

Epidemiological trends of pancreatic and gastrointestinal neuroendocrine tumors in Japan: a nationwide survey analysis

“…Meanwhile, in the present survey, the frequency of NEC among all GEP-NETs in Japan was 6.7 % (225/3,366). Interestingly, the frequency of NEC in NF-PNETs was 9.7 %, which is substantially higher than that reported in Western nations, where NEC in NF-PNETs is uncommon [8]. However, with regard to the grade of WHO calcification, the percentage of distant metastases in patients with NEC at initial diagnosis was high compared with that in patients with NET G1/G2.…”

“…The incidences of new-onset PNETs in 2005 and 2010 were about 1.01 and 1.27 per 100,000 people, respectively, indicating a 5-year increase in the incidence of new-onset PNETs. Interestingly, the percentage of NFPNETs increased from 42.8 % in 2005 to 65.5 % in 2010, approaching that of Western nations [2,7,8]. There are 2 possible reasons for this.…”

“…Although surgical total excision is the standard treatment [37], some studies report that when radical treatment is difficult, debulking surgery of primary lesions and liver metastatic lesions effectively alleviate symptoms and improve prognosis [4,34,37]. On the other hand, in cases of unresectable advanced tumors, treatment aiming to improve prognosis by inhibiting tumor growth and improving clinical symptoms is necessary [8,13,27]. For this purpose, it is important to understand patient backgrounds, particularly epidemiological background, and be aware of the epidemiological differences between Japanese and Western populations.…”

Behavior of small, asymptomatic, nonfunctioning pancreatic neuroendocrine tumors (NF-PNETs)

“…4 Surgical resection is the treatment of choice for patients with functional tumors, and it is preferred for most of the NFPNETs. [5][6][7] It is debatable whether all of the small and asymptomatic lesions should be routinely resected. 8 There is insufficient information about the natural history of NF-PNETs, especially when they are small.…”

Prognostic factors for gastroenteropancreatic neuroendocrine neoplasms (GEP-NENs): what’s better?

“…On the other hand, biological markers might provide early information on prognosis and even allow the estimation of the risk of neoplastic transformation [8]. Interestingly, while the prognostic factors for pancreatic WD-GEP-NENs were extensively investigated during the studies on the mTOR pathway [9], less extensive evidence is available for ileal disease although information on prognostic biomarkers is urgently required for these neoplasms. Indeed, differing from pancreatic disease, ileal WD-GEP-NENs-presenting in almost all cases Ki67 < 2%-are classified as NET G1 according to the 2010 WHO classification, regardless of their clinical features.…”