Neuroendocrine Tumors

Gastroenterol Clin North Am. 2016 Sep;45(3):487-507. doi: 10.1016/j.gtc.2016.04.007.

Abstract

Neuroendocrine tumors are increasingly diagnosed, either incidentally as part of screening processes, or for symptoms, which have commonly been mistaken for other disorders initially. The diagnostic workup to characterize tumor behaviour and prognosis focuses on histologic, anatomic, and functional imaging assessments. Several therapeutic options exist for patients ranging from curative and debulking surgery through to liver-directed therapies and systemic treatments. Multimodal therapies are often required over the patient's disease history. The management paradigm can be complex but should be focused on curative resections and then on controlling symptoms and limiting disease progression. There are several new systemic therapies that have completed phase 3 studies with new compounds being studied in phase 2. Genetic and epigenetic markers may lead to a new era of personalised therapy in the future.

Keywords: Carcinoid; Diagnostics; Multimodal; Neuroendocrine; Therapy; Tumor.

Publication types

  • Review

MeSH terms

  • Antineoplastic Agents / therapeutic use
  • Antineoplastic Agents, Hormonal / therapeutic use
  • Chromogranin A / metabolism
  • Digestive System Surgical Procedures
  • Embolization, Therapeutic
  • Fluorodeoxyglucose F18
  • Gallium Radioisotopes
  • Gastrointestinal Neoplasms / diagnosis*
  • Gastrointestinal Neoplasms / metabolism
  • Gastrointestinal Neoplasms / pathology
  • Gastrointestinal Neoplasms / therapy
  • Hepatic Artery
  • Humans
  • Hydroxyindoleacetic Acid / metabolism
  • Liver Neoplasms / secondary
  • Liver Neoplasms / therapy
  • Magnetic Resonance Imaging
  • Malignant Carcinoid Syndrome / therapy
  • Metastasectomy
  • Neoplasm Staging
  • Neuroendocrine Tumors / diagnosis*
  • Neuroendocrine Tumors / metabolism
  • Neuroendocrine Tumors / secondary
  • Neuroendocrine Tumors / therapy
  • Octreotide / therapeutic use
  • Organometallic Compounds
  • Pancreatic Neoplasms / diagnosis*
  • Pancreatic Neoplasms / metabolism
  • Pancreatic Neoplasms / pathology
  • Pancreatic Neoplasms / therapy
  • Positron Emission Tomography Computed Tomography
  • Radiopharmaceuticals
  • Receptors, Somatostatin / metabolism
  • Serotonin / metabolism
  • Tomography, X-Ray Computed

Substances

  • Antineoplastic Agents
  • Antineoplastic Agents, Hormonal
  • Chromogranin A
  • Gallium Radioisotopes
  • Organometallic Compounds
  • Radiopharmaceuticals
  • Receptors, Somatostatin
  • Fluorodeoxyglucose F18
  • Serotonin
  • Hydroxyindoleacetic Acid
  • gallium Ga 68 dotatate
  • Octreotide