Controversies in the treatment of digestive neuroendocrine tumors

Abstract

Gastroenteropancreatic neuroendocrine tumors (NETs) have an incidence of 2.39 per 100,000 inhabitants per year, and a prevalence of 35 cases per 100,000 inhabitants; the gap between these rates is due to the relatively long survival time of these tumors, which can be thus considered as chronic oncological diseases. Recently, more therapeutic options have become available, but criteria for defining timing, priority and sequence of different therapeutic options are still debated. This review offers an overview of pancreatic and small bowel NETs, critically underlining the issues that still need to be clarified and some controversial issues on the therapeutic approach for NET patients.

Incidence of Gastrointestinal Neuroendocrine Tumor: Case Series, Armed Forces Hospital Southern Region, Hospital-Based Tumor Board Registry

“…Actually, the optimal therapeutic sequence should be based on the evaluation of at least three major issues [ 16 ]: Tumor characterization (primary site, histological diagnosis, and staging) Patient's clinical status (performance status, clinical picture, prior treatments, and comorbidities) Defining the objectives of care …”

Current and upcoming radionuclide therapies in the direction of precision oncology: A narrative review

“…Current guidelines recommend PRRT as an option only in advanced NET. In the early stages, Octreotide and other targeted therapies like sunitinib, everolimus, capecitabine, and temozolomide have shown response in this setting [56] . It is notable that, as early as 2009, PRRT has been used as neoadjuvant therapy and successfully reported in a case report [57] .…”

Gastric mixed adenoneuroendocrine carcinoma occurring 30 years after a gastroenterostomy

“…(GEP-NENs) represent a heterogeneous group of rare tumors. Generally, the incidence of GEP-NENs has increased worldwide over the past decades, with the small intestine, rectum, and pancreas as the most common tumor locations [1]. GEP-NENs were divided according to their site of origin into foregut (lung, stomach, duodenum and pancreas), midgut (distal jejunum, ileum, appendix, and cecum) and hindgut (colon and rectum) neuroendocrine tumors [2].…”