Neuroendocrine tumour management: a team approach

Banfield, Angela; Green, S

doi:10.12968/hmed.2005.66.1.17534

Cited by 6 publications

(5 citation statements)

References 28 publications

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“…For this reason, cases should be discussed in a specialist NET multidisciplinary meeting (MDM) to ensure all investigation and treatment modalities are appropriately explored. 100 Importantly, a histopathologist with an interest in NETs should review all cases to ensure accurate subtyping and grading given the direct impact on clinical management. Studies from centres with experience in managing NET patients have shown improved survival.…”

Section: Therapies In Advanced Diseasementioning

confidence: 99%

Review article: the investigation and management of gastric neuroendocrine tumours

Basuroy

Haji

Ramage

et al. 2014

Aliment Pharmacol Ther

130

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Summary Background Gastric carcinoids (GCs) or neuroendocrine tumours (NETs) are increasingly identified at endoscopy, and account for 0.6–2% of all gastric polyps identified. The SEER database in the US has demonstrated a rising incidence of gastric NETs amongst all NETs; from 2.2% between 1950 and 1969 to 6.0% between 2000 and 2007. Aim To review the literature and assist clinicians in managing patients with GCs. Methods A literature search was conducted through MEDLINE using search terms: gastric, carcinoid, neuroendocrine tumour, therapy, endoscopy, mucosal resection, submucosal dissection. Relevant articles were identified through manual review. The reference lists of these articles were reviewed to include further appropriate articles. Results There are three types of GCs with important epidemiological, pathophysiological, histological and endoscopic differences that affect prognosis and management. Type 1 and 2 GCs develop in the context of hypergastrinaemia that originates from achlorhydria in atrophic gastritis and a gastrinoma, respectively. Type 3 GCs occur sporadically and independent of gastrin. The histological type, grade and Ki67 index are used to determine prognosis and direct clinical management. Type 1 GCs >1 cm in size and type 2 GCs should be assessed for invasion beyond the submucosa with EUS prior to endoscopic resection with EMR or ESD. Type 3 GCs should be managed as per recommendations for gastric adenocarcinoma. The treatment of advanced disease is multimodal. Conclusions Patients with gastric carcinoids should be discussed in a specialist neuroendocrine tumour multidisciplinary meeting to ensure all treatment options are explored in localised and advanced disease. Areas of controversy exist that need further research.

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Section: Therapies In Advanced Diseasementioning

confidence: 99%

Review article: the investigation and management of gastric neuroendocrine tumours

Basuroy

Haji

Ramage

et al. 2014

Aliment Pharmacol Ther

130

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“…Segmental resections were carried out for presumably benign lesions. Very interestingly, the retrospective reclassification and reevaluation of tumor sections revealed carcinoma in 11 subjects (10 LGCs, 1 HGC) treated by organ-sparing segmental resection ( Table 2). The present study will focus on survival analysis of these particular cases later on and compare their outcome with those who received oncologic resections.…”

Section: Resections For Primary Tumors With and Without Concomitant Mmentioning

confidence: 99%

“…However, from a clinician's point of view, the question of how to best treat a patient arises preoperatively. 10 Endosonography (EUS) and fine needle aspiration (FNA) are invasive diagnostic techniques that may help verify the histopathologic features of the tumor preoperatively. 11 Even laparoscopy has been proposed for preoperative staging.…”

mentioning

confidence: 99%

Aggressive Surgery Improves Long-term Survival in Neuroendocrine Pancreatic Tumors

Schurr¹,

Strate²,

Rese³

et al. 2007

Annals of Surgery

169

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“…26 Treatment strategies for neuroendocrine liver metastases include antihormonal therapy, interferon and chemotherapeutic treatment, regional ablation, and surgery. 27,28 Analyses of the Surveillance, Epidemiology, and End Result database have shown 5-year OS rates of 35% in G1 and G2 neuroendocrine tumors and of < 5% for G3 tumors. However, a 5-year OS rate of > 50% has been described incertain G1 patients after combined medical-surgical therapy without LT. 29 Together with the 2 preexisting guidelines, LT should be considered a viable option in patients with well-differentiated neuroendocrine tumors (G1/G2), a Ki-67 index of <10%, up to 75% liver involvement, no extrahepatic disease, age <55 years, primary tumor removed before LT, and stable disease for at least 6 months, with no major extrahepatic resection to be performed concurrently with LT. 29,30 In their analysis of neuroendocrine liver metastases in series with > 100 patients, including a synopsis of UNOS and European databases, Hackl and associates reported 5-year OS rates of 47% to 58%.…”

Section: Hepatoblastomamentioning

confidence: 99%

Untitled

Haberal

2017

Exp Clin Transplant

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Liver transplant is now an acceptable and effective treatment for specific nonhepatocellular malignancies. Worldwide, hilar cholangiocarcinoma accounts for 3% of all primary gastrointestinal malignancies and for 10% of primary hepatobiliary malignancies. For patients who have early-stage, unresectable cholangiocarcinoma, liver transplant preceded by neoadjuvant radiotherapy can result in tumor-free margins, accomplish a radical resection, and treat the underlying primary sclerosing cholangitis when present. Hepatic epithelioid hemangioendothelioma is a rare tumor of vascular origin with a variable malignant potential. Excellent results have been reported with liver transplant for patients with unresectable hepatic epithelioid hemangioendothelioma, with 1-year and 10-year survival rates of 96% and 72%. Hepatoblastoma is the most common primary hepatic malignancy in children. The long-term survival rate after transplant ranges from 66% to 77% in patients with unresectable tumors and good response to chemotherapy. Metastatic liver disease is not an indication for liver transplant, with the exception of cases in which the primary tumor is a neuroendocrine tumor. Indication for liver transplant for hepatic metastasis from neuroendocrine tumors is mainly for patients with unresectable tumors and for palliation of medically uncontrollable symptoms. Posttransplant survival in those patients with low tumor activity index is excellent, despite recurrence of the tumor. Some recent data on liver transplant for unresectable hepatic metastases from colorectal cancer have reported limited survival benefits compared with previous reports. However, due to the high rate of tumor recurrence in a very short time after liver transplant, especially in the era of organ shortage, this indication has not been favored by the transplant community. The indications for liver transplant for nonhepatocellular carcinoma malignancy and its limitations have evolved dramatically over the past decades and will continue to be redefined through future research and investigations.

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Neuroendocrine tumour management: a team approach

Abstract: This article gives an overview of neuroendocrine tumours of the gut, liver and pancreas and will make the case for a multidisciplinary approach to management.

Cited by 6 publications

References 28 publications

Review article: the investigation and management of gastric neuroendocrine tumours

Review article: the investigation and management of gastric neuroendocrine tumours

Aggressive Surgery Improves Long-term Survival in Neuroendocrine Pancreatic Tumors

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