scholarly journals Role of Endoscopic Ultrasound in Gastroenteropancreatic Neuroendocrine Tumors and Update on Their Treatment

2013 ◽  
Vol 47 (1) ◽  
pp. 54-60
Author(s):  
Vishal Sharma ◽  
Surinder Singh Rana ◽  
Deepak Kumar Bhasin
Keyword(s):  
Neuroendocrine Tumors ◽  
Endoscopic Ultrasound ◽  
Imaging Techniques ◽  
Somatostatin Analogs ◽  
Neuroendocrine Cells ◽  
Molecular Therapy ◽  
Long Term Results ◽  
Gi Tract ◽  
Gastroenteropancreatic Neuroendocrine Tumors

ABSTRACT The gastroenteropancreatic (GEP) neuroendocrine tumors (NETs) are rare tumors and include all tumors arising from the gastrointestinal (GI) or pancreatic neuroendocrine cells. They can occur anywhere in the GI tract with the small intestine, pancreas and rectum being the common GI sites. Because of nonspecific symptoms they are difficult to diagnose and diagnosis is often delayed by years. Advancement in cross-sectional imaging techniques and advent of radionuclide-labeled somatostatin analogs have improved our accuracy of diagnosis and staging GEP NETs. Endoscopic ultrasound (EUS) with its unique combination of endoscopy and ultrasound provides high resolution images of GI tract wall as well as the surrounding solid parenchymal organs and therefore is an important investigation for the diagnosis and staging of GEP NETs. Surgery is the treatment of choice with good long-term results in patients with localized GEP-NETs. Control of symptoms in functional NETs is warranted to improve the quality of life of the patient. Somatostatin and its analogs like octreotide and lanreotide have been used to control symptoms because of functional NETs. The management of metastatic GEP NETs includes control of symptoms and therapy to decrease/stop tumor growth that includes somatostatin and its analogs and chemotherapy. Newer therapeutic modalities like peptide receptor radionuclide therapy (PRRT) and molecular therapy hold considerable promise. How to cite this article Rana SS, Sharma V, Bhasin DK. Role of Endoscopic Ultrasound in Gastroenteropancreatic Neuroendocrine Tumors and Update on Their Treatment. J Postgrad Med Edu Res 2013;47(1):54-60.

scholarly journals Interaction of race and pathology for neuroendocrine tumors: Epidemiology, natural history, or racial disparity?

2019 ◽  
Vol 37 (4_suppl) ◽  
pp. 376-376
Author(s):  
Rachel M Lee ◽  
Danielle K DePalo ◽  
Alexandra G Lopez-Aguiar ◽  
Mohammad Yahya Zaidi ◽  
Flavio G. Rocha ◽  
...  
Keyword(s):  
Quality Of Care ◽  
Neuroendocrine Tumors ◽  
Prognostic Value ◽  
Oncologic Outcomes ◽  
Gastroenteropancreatic Neuroendocrine Tumors ◽  
Curative Intent ◽  
Black And White ◽  
The Us

376 Background: The prognostic value of pathologic variables is not consistent for gastroenteropancreatic neuroendocrine tumors (GEP-NETs). We previously demonstrated a limited prognostic role of lymph node (LN) positivity in small bowel NETs (SBNET) compared to pancreatic NETs (panNET). Although minority race is often associated with worse cancer outcomes, the interaction of race with pathologic and oncologic outcomes of pts with GEP-NETS is not known. Methods: Pts with GEP-NETs who underwent curative intent resection at eight institutions of the US NET Study Group from 2000-16 were included. Given few pts of other races, only Black and White race pts were analyzed. Results: Of 2,182 pts, 1,143 met inclusion criteria. Median age was 58 yrs, median follow up was 3 yrs, 48% were male, 14% (n = 157) were Black, and 86% (n = 986) were White. Black pts were more likely uninsured (7 vs 2%, p = 0.005), had symptomatic bleeding (13 vs 7%, p = 0.006), required emergency surgery (7 vs 3%, p = 0.003), and had LN positive disease (47 vs 36%, p = 0.016). Despite this, Black pts had improved 5 yr recurrence free survival (RFS) compared to White pts (90 vs 80%, p = 0.008). The quality of care received was comparable between both groups, demonstrated by similar LN yield at surgery, neg margin resection rate, post-op complications, and need for reoperation or readmission (all p > 0.05). Black pts were more likely to have SBNET (22 vs 13%) and less likely to have panNET (43 vs 68%) compared to White pts (p < 0.001). Consistent with prior data, pts with LN pos panNET had decreased 5yr RFS (67 vs 83%, p = 0.001); however, for SBNET, LN involvement was not prognostic (77 vs 96%, p = 0.08). The prognostic value of LN pos disease was similar between Black and White pts in both SBNET (p = 0.34) and panNET (p = 0.95). Conclusions: Black pts with GEP-NET present with more advanced disease, including higher LN positivity. Despite this, Black pts have improved RFS compared to White pts. Although there may be delays in seeking or reaching care, Black pts received similar quality of care compared to White pts. The improved RFS seen in Black pts may be attributed to the epidemiologic differences in the site of presentation of GEP-NETs and variable prognostic value of LN pos disease.

Abdominal Manifestations of Neuroendocrine Tumors

2019 ◽  
Vol 03 (01) ◽  
pp. 014-029
Author(s):  
Leonardo Marcal ◽  
Madhavi Patnana ◽  
Sireesha Yedururi ◽  
Hubert Chuang ◽  
Catherine Devine ◽  
...  
Keyword(s):  
Small Bowel ◽  
Neuroendocrine Tumors ◽  
Multidisciplinary Approach ◽  
Imaging Techniques ◽  
Tumor Biology ◽  
Imaging Features ◽  
Gastroenteropancreatic Neuroendocrine Tumors ◽  
New Developments ◽  
Clinical Presentations ◽  
Unites States

AbstractDespite being rare, the incidence and prevalence of gastroenteropancreatic neuroendocrine tumors (NETs) is rising. They are a heterogeneous group of tumors with differences in clinical presentations, genetics, and imaging features. Advances in pathological classification, imaging (including recent radiotracer approval for functional imaging in the Unites States), and therapy have impacted management of these tumors. It is important in the multidisciplinary approach to patient care to be familiar with the tumor biology, imaging techniques for diagnosis and staging, and therapeutic options. This article will discuss these new developments, particularly focusing on pancreatic and small bowel NETs.

scholarly journals Nutritional Complications and the Management of Patients with Gastroenteropancreatic Neuroendocrine Tumors

2019 ◽  
Vol 110 (5) ◽  
pp. 430-442 ◽  
Author(s):  
Erin Laing ◽  
Nicole Kiss ◽  
Michael Michael ◽  
Meinir Krishnasamy
Keyword(s):  
Clinical Practice ◽  
Neuroendocrine Tumors ◽  
Dietary Habits ◽  
Somatostatin Analogs ◽  
The United States ◽  
The Body ◽  
Care Needs ◽  
Gastroenteropancreatic Neuroendocrine Tumors ◽  
Vitamin Deficiencies ◽  
The Impact

Neuroendocrine tumors (NETs) have increased in incidence and prevalence over the past 2 decades and affect approximately 170,000 people in the United States alone. Gastroenteropancreatic (GEP) NETs (GEP NET) are a heterogeneous group of rare tumors that have distinct effects on the body due to their tumor location and potential to secrete hormones and peptides. Clinical practice guidelines and consensus guidelines for GEP NETs with regard to best practice for diagnosis, treatment, and medical management are available, but the supportive care needs and optimal nutritional management of patients affected by these unique tumors remain under-researched: evidence to guide clinical practice is lacking. The pathophysiology of the disease and its treatment can cause various symptoms that can have significant effects on vitamin synthesis and absorption, dietary habits, weight change, and appetite. Deficiency of fat-soluble vitamins and niacin exists amongst patients with GEP NET, particularly those on treatment with somatostatin analogs and with serotonin-secreting tumors, respectively. Malnutrition and dietary modification amongst patients with GEP NET is more prevalent than initially thought: up to 25% of inpatients with GEP NET are malnourished. Food intolerance is also reported in up to 40–90% of these patients, though its misdiagnosis is common. This review summarizes the evidence regarding the impact of GEP NET and its treatment on nutritional factors in these patients with emphasis on malnutrition, vitamin deficiencies, dietary intake, and quality of life. Recommendations for clinical practice and research approaches to address these nutritional issues are discussed.

scholarly journals Update on the Management of Gastroenteropancreatic Neuroendocrine Tumors With Emphasis on the Role of Imaging

2013 ◽  
Vol 201 (4) ◽  
pp. 811-824 ◽  
Author(s):  
Kyung Won Kim ◽  
Katherine M. Krajewski ◽  
Mizuki Nishino ◽  
Jyothi P. Jagannathan ◽  
Atul B. Shinagare ◽  
...  
Keyword(s):  
Neuroendocrine Tumors ◽  
Gastroenteropancreatic Neuroendocrine Tumors

scholarly journals Management Options for Advanced Low or Intermediate Grade Gastroenteropancreatic Neuroendocrine Tumors: Review of Recent Literature

2017 ◽  
Vol 2017 ◽  
pp. 1-14 ◽  
Author(s):  
Vladimir Neychev ◽  
Electron Kebebew
Keyword(s):  
Neuroendocrine Tumors ◽  
Tryptophan Hydroxylase ◽  
Management Strategies ◽  
Somatostatin Analogs ◽  
Treatment Strategies ◽  
Peptide Receptor Radionuclide Therapy ◽  
Phase Iii ◽  
Management Options ◽  
Intermediate Grade ◽  
Gastroenteropancreatic Neuroendocrine Tumors

Our understanding of the biology, genetics, and natural history of neuroendocrine tumors (NETs) of the gastrointestinal tract and pancreas has improved considerably in the last several decades and the spectrum of available therapeutic options is rapidly expanding. The management of patients with metastatic low or intermediate grade NETs has been revolutionized by the development of new treatment strategies such as molecular targeting therapies with everolimus and sunitinib, somatostatin analogs, tryptophan hydroxylase inhibitors, and peptide receptor radionuclide therapy that can be used alone or as a multimodal approach with or without surgery. To further define and clarify the utility, appropriateness, and the sequence of the growing list of available therapies for this patient population will require more high level evidence; however, data from well-designed randomized phase III clinical trials is rapidly accumulating that will further stimulate development of new management strategies. It is therefore important to thoroughly review emerging evidence and report major findings in frequent updates, which will expand our knowledge and contribute to a better understanding, characterization, and management of advanced NETs.

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