State of the Art in Endoscopic Therapy for the Management of Gastroenteropancreatic Neuroendocrine Tumors

Curr Treat Options Oncol. 2022 Jul;23(7):1014-1034. doi: 10.1007/s11864-022-00986-w. Epub 2022 May 5.

Abstract

Gastroenteropancreatic neuroendocrine neoplasms (GEP NENs) comprise a heterogeneous group of slow growing tumors arising from the neuroendocrine cells of the gastrointestinal (GI) tract. Although they are considered relatively rare, their incidence is rising and it is believed that the more frequent use of endoscopy and imaging studies have at least in part contributed to the increased diagnosis especially of localized neoplasms. The management of these neoplasms should be guided by a multidisciplinary NEN team following appropriate staging investigations. Localized neoplasms of the GI tract may be suitable for endoscopic therapy, while patients with pancreatic NENs, unsuitable for surgery, should be considered for endoscopic ultrasound (EUS)-guided ablation. In this review, we discuss the evidence regarding endoscopic resection of luminal NENs and EUS-guided therapy of pancreatic NENs. The efficacy, safety, and other longer-term outcomes of these techniques are summarized. In conclusion, this review of endoscopic therapies for localized NENs may be a useful guide for NEN clinicians and endoscopists who are considering these therapeutic options for the management of focal GEP NENs.

Keywords: Ablation; EMR; ESD; Gastrointestinal neuroendocrine tumors.

Publication types

  • Review

MeSH terms

  • Endoscopy
  • Gastrointestinal Neoplasms* / diagnosis
  • Gastrointestinal Neoplasms* / surgery
  • Humans
  • Intestinal Neoplasms* / diagnosis
  • Intestinal Neoplasms* / surgery
  • Neuroendocrine Tumors* / diagnosis
  • Neuroendocrine Tumors* / surgery
  • Pancreatic Neoplasms* / diagnosis
  • Pancreatic Neoplasms* / surgery
  • Stomach Neoplasms* / diagnosis
  • Stomach Neoplasms* / surgery

Supplementary concepts

  • Gastro-enteropancreatic neuroendocrine tumor