SEOM clinical guidelines for the diagnosis and treatment of gastroenteropancreatic neuroendocrine neoplasms (GEP-NENs) 2014

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• 作者：R. Garcia-Carbonero (1)
  P. JImenez-Fonseca (2)
  A. Teulé (3)
  J. Barriuso (4) (5)
  I. Sevilla (6)
  
• 关键词：Guidelines ; Neuroendocrine tumors ; Neuroendocrine neoplasms ; Enteropancreatic ; Diagnosis ; Therapy
• 刊名：Clinical and Translational Oncology
• 出版年：2014
• 出版时间：December 2014
• 年：2014
• 卷：16
• 期：12
• 页码：1025-1034
• 全文大小：1,653 KB
• 参考文献：1. Lawrence B, Gustafsson BI, Chan A, Svejda B, Kidd M, Modlin IM. The epidemiology of gastroenteropancreatic neuroendocrine tumors. Endocrinol Metab Clin N Am. 2011;40:1-8. CrossRef
  2. Garcia-Carbonero R, Capdevila J, Crespo-Herrero G, Díaz-Pérez JA, Martínez Del Prado MP, Alonso Ordu?a V, et al. Incidence, patterns of care and prognostic factors for outcome of gastroenteropancreatic neuroendocrine tumors (GEP-NETs): results from the National Cancer Registry of Spain (RGETNE). Ann Oncol. 2010;21:1794-03. CrossRef
  3. Modlin IM, Oberg K, Chung DC, Jensen RT, de Herder WW, Thakker RV, et al. Gastroenteropancreatic neuroendocrine tumours. Lancet Oncol. 2008;9:61-2. CrossRef
  4. Garcia-Carbonero R, Sevilla I, Aller J, Martin E (eds). Manual de Diagnóstico y Tratamiento de los Tumores Neuroendocrinos. In: Editorial TACTICS Medicina y Desarrollo S.L., 2a Edición (4 de Octubre de 2013) (ISBN 978-84-695-8312-8). http://www.getne.org/áreadeProfesionales/MaterialdetrabajoenTNEs.aspx.
  5. Rindi G, Arnold R, Bosman FT. Nomenclature and classification of neuroendocrine neoplasms of the digestive system. In: Bosman TF, Carneiro F, Hruban RH, Theise ND, editors. WHO classification of tumours of the digestive system. 4th ed. Lyon: International Agency for Research on cancer (IARC); 2010. p. 13.
  6. Rindi G, Kl?ppel G, Alhman H, Caplin M, Couvelard A, de Herder WW, et al. TNM staging of foregut (neuro)endocrine tumors: a consensus proposal including a grading system. Virchows Arch. 2006;449:395-01. CrossRef
  7. Rindi G, Kl?ppel G, Couvelard A, Komminoth P, K?rner M, Lopes JM, et al. TNM staging of midgut and hindgut (neuro) endocrine tumors: a consensus proposal including a grading system. Virchows Arch. 2007;451:757-2. CrossRef
  8. Sobin L, Gospodarowicz M, Wittekind C (eds). TNM classification of malignant tumours, 7th edn. Oxford: Wiley-Blackwell; 2010.
  9. García-Carbonero R, Vilardell F, Jiménez-Fonseca P, González-Campora R, González E, Cuatrecasas M, et al. Guidelines for biomarker testing in gastroenteropancreatic neuroendocrine neoplasms: a national consensus of the Spanish Society of Pathology and the Spanish Society of Medical Oncology. Clin Transl Oncol. 2014;16(3):243-6. CrossRef
  10. Akyildiz HY, Mitchell J, Milas M, Siperstein A, Berber E. Laparoscopic radiofrequency thermal ablation of neuroendocrine hepatic metastases: long-term follow-up. Surgery. 2010;148(6):1288-3. CrossRef
  11. Yang TX, Chua TC, Morris DL. Radioembolization and chemoembolization for unresectable neuroendocrine liver metastases—a systematic review. Surg Oncol. 2012;21(4):299-08. CrossRef
  12. Mayo SC, de Jong MC, Bloomston M, Pulitano C, Clary BM, Reddy SK, et al. Surgery versus intra-arterial therapy for neuroendocrine liver metastasis: a multicenter international analysis. Ann Surg Oncol. 2011;18(13):3657-5. CrossRef
  13. Rinke A, Müller HH, Schade-Brittinger C, Klose KJ, Barth P, Wied M, et al. PROMID Study Group. Placebo-controlled, double-blind, prospective, randomized study on the effect of octreotide LAR in the control of tumor growth in patients with metastatic neuroendocrine midgut tumors: a report from the PROMID Study Group. J Clin Oncol. 2009;27:4656-3. CrossRef
  14. Caplin M, Ruszniewski P, Pavel M, ?wik?a JB, Phan A, Raderer M, et al. A randomized, double blind, placebo controlled study of lanreotide antiproliferative response in patients with gastroenteropancreatic neuroendocrine tumors (CLARINET). In Presented at ECC 2013, abstract LBA3.
  15. Kwekkeboom DJ, de Herder WW, Kam BL, van Eijck CH, van Essen M, Kooij PP, et al. Treatment with the radiolabeled somatostatin analog [177 Lu-DOTA 0, Tyr3]octreotate: toxicity, efficacy, and survival. J Clin Oncol. 200
• 作者单位：R. Garcia-Carbonero (1)
  P. JImenez-Fonseca (2)
  A. Teulé (3)
  J. Barriuso (4) (5)
  I. Sevilla (6)
  
  1. Medical Oncology Department, Hospital Universitario Virgen del Rocio, Instituto de Biomedicina de Sevilla (IBIS) (Universidad de Sevilla, CSIC, HUVR), Center affiliated to the Red Temática de Investigación Cooperativa en Cancer (RTICC), Instituto Carlos III, Spanish Ministry of Science and Innovation, Av. Manuel Siurot, s/n, 41013, Seville, Spain
  2. Medical Oncology Department, Hospital Universitario Central de Asturias, Asturias, Spain
  3. Medical Oncology Department, Instituto Catalán de Oncología (ICO), Barcelona, Spain, Center affiliated to the Red Temática de Investigación Cooperativa en Cancer (RTICC), Instituto Carlos III, Spanish Ministry of Science and Innovation, Seville, Spain
  4. Faculty of Life Sciences, University of Manchester, Manchester, UK
  5. Department of Medical Oncology, The Christie NHS Foundation Trust, Manchester, UK
  6. Medical Oncology Department, Hospital Universitario Virgen de la Victoria y Hospital Regional Universitario, Málaga, Spain
  
• ISSN：1699-3055

文摘

GEP-NENs are a challenging family of tumors of growing incidence and varied clinical management and behavior. Diagnostic techniques have substantially improved over the past decades and significant advances have been achieved in the understanding of the molecular pathways governing tumor initiation and progression. This has already translated into relevant advances in the clinic. This guideline aims to provide practical recommendations for the diagnosis and treatment of GEP-NENs. Diagnostic workup, histological and staging classifications, and the different available therapeutic approaches, including surgery, liver-directed ablative therapies, peptide receptor radionuclide therapy, and systemic hormonal, cytotoxic or targeted therapy, are briefly discussed in this manuscript. Clinical presentation (performance status, comorbidities, tumor-derived symptoms and hormone syndrome in functioning tumors), histological features [tumor differentiation, proliferation rate (Ki-67), and expression of somatostatin receptors], disease localization and extent, and resectability of primary and metastatic disease, are all key issues that shall be taken into consideration to appropriately tailor therapeutic strategies and surveillance of these patients.