Follow-up Recommendations for Completely Resected Gastroenteropancreatic Neuroendocrine Tumors

JAMA Oncol. 2018 Nov 1;4(11):1597-1604. doi: 10.1001/jamaoncol.2018.2428.

Abstract

There is no consensus on optimal follow-up for completely resected gastroenteropancreatic neuroendocrine tumors. Published guidelines for follow-up are complex and emphasize closer surveillance in the first 3 years after resection. Neuroendocrine tumors have a different pattern and timescale of recurrence, and thus require more practical and tailored follow-up. The Commonwealth Neuroendocrine Tumour Collaboration convened an international multidisciplinary expert panel, in collaboration with the North American Neuroendocrine Tumor Society, to create patient-centered follow-up recommendations for completely resected gastroenteropancreatic neuroendocrine tumors. This panel used the RAND/UCLA (University of California, Los Angeles) Appropriateness Method to generate recommendations. A large international survey was conducted outlining current the surveillance practice of neuroendocrine tumor practitioners and shortcomings of the current guidelines. A systematic review of available data to date was supplemented by recurrence data from 2 large patient series. The resultant guidelines suggest follow-up for at least 10 years for fully resected small-bowel and pancreatic neuroendocrine tumors and also identify clinical situations in which no follow-up is required. These recommendations stratify follow-up strategies based on evidence-based prognostic factors that allow for a more individualized patient-centered approach to this complex and heterogeneous malignant neoplasm.

Publication types

  • Systematic Review

MeSH terms

  • Follow-Up Studies
  • Humans
  • Intestinal Neoplasms / pathology
  • Intestinal Neoplasms / surgery*
  • Intestinal Neoplasms / therapy*
  • Neuroendocrine Tumors / pathology
  • Neuroendocrine Tumors / surgery*
  • Neuroendocrine Tumors / therapy*
  • Pancreatic Neoplasms / pathology
  • Pancreatic Neoplasms / surgery*
  • Pancreatic Neoplasms / therapy*
  • Stomach Neoplasms / pathology
  • Stomach Neoplasms / surgery*
  • Stomach Neoplasms / therapy*

Supplementary concepts

  • Gastro-enteropancreatic neuroendocrine tumor