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Neuroendocrine and Adrenal Tumors, Version 2.2021, NCCN Clinical Practice Guidelines in Oncology
Manisha H Shah1, Whitney S Goldner2, Al B Benson3
11The Ohio State University Comprehensive Cancer Center - James Cancer Hospital and Solove Research Institute.
Abstract:
The NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines) for Neuroendocrine and Adrenal Gland Tumors focus on the diagnosis, treatment, and management of patients with neuroendocrine tumors (NETs), adrenal tumors, pheochromocytomas, paragangliomas, and multiple endocrine neoplasia. NETs are generally subclassified by site of origin, stage, and histologic characteristics. Appropriate diagnosis and treatment of NETs often involves collaboration between specialists in multiple disciplines, using specific biochemical, radiologic, and surgical methods. Specialists include pathologists, endocrinologists, radiologists (including nuclear medicine specialists), and medical, radiation, and surgical oncologists. These guidelines discuss the diagnosis and management of both sporadic and hereditary neuroendocrine and adrenal tumors and are intended to assist with clinical decision-making. This article is focused on the 2021 NCCN Guidelines principles of genetic risk assessment and counseling and recommendations for well-differentiated grade 3 NETs, poorly differentiated neuroendocrine carcinomas, adrenal tumors, pheochromocytomas, and paragangliomas.
Insights
The NCCN Guidelines offer updated strategies for diagnosing and managing neuroendocrine tumors (NETs) and adrenal gland tumors. They emphasize multidisciplinary care and genetic risk assessment for various tumor types.
Area of Science:
- Oncology
- Endocrinology
- Genetics
Background:
- Neuroendocrine tumors (NETs) and adrenal gland tumors require specialized, multidisciplinary management.
- Current guidelines are essential for standardizing diagnosis and treatment protocols.
- Genetic factors play a significant role in hereditary forms of these tumors.
Purpose of the Study:
- To present the 2021 NCCN Clinical Practice Guidelines for Neuroendocrine and Adrenal Gland Tumors.
- To detail principles of genetic risk assessment and counseling.
- To provide recommendations for specific tumor types including NETs and adrenal tumors.
Main Methods:
- Review of the 2021 NCCN Guidelines.
- Focus on diagnostic criteria, staging, and treatment modalities.
- Inclusion of genetic risk assessment and counseling principles.
Main Results:
- Comprehensive guidelines for diagnosis and management of NETs, adrenal tumors, pheochromocytomas, paragangliomas, and multiple endocrine neoplasia.
- Specific recommendations for well-differentiated grade 3 NETs, poorly differentiated neuroendocrine carcinomas, and adrenal tumors.
- Emphasis on collaborative, multidisciplinary specialist involvement.
Conclusions:
- The NCCN Guidelines provide a framework for optimal clinical decision-making in neuroendocrine and adrenal gland tumors.
- Genetic risk assessment is a key component in managing hereditary forms of these conditions.
- Adherence to these guidelines ensures comprehensive patient care through integrated specialist expertise.
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