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[Gastroenteropancreatic neuroendocrine neoplasms-Surgery in a multimodal concept]

  • 0Klinik für Viszeral‑, Thorax- und Gefäßchirurgie, Universitätsklinikum Marburg, Baldingerstraße, Marburg, Deutschland. katharina.holzer@uk-gm.de.
Chirurgie (heidelberg, Germany) +

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June 27, 2024

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June 27, 2024

View abstract on PubMed

Summary

This summary is machine-generated.

Gastroenteropancreatic neuroendocrine neoplasms (GEP-NENs) can spread to lymph nodes and liver, even when well-differentiated. While surgery offers excellent outcomes for resectable GEP-NENs, advanced treatments improve survival for metastatic disease.

Area Of Science

  • Oncology
  • Gastroenterology
  • Endocrinology

Background

  • Gastroenteropancreatic neuroendocrine neoplasms (GEP-NENs) originate primarily in the small intestine and pancreas.
  • Disease progression in GEP-NENs is highly variable, influenced by tumor differentiation (G1-G3).
  • GEP-NENs exhibit a high metastatic potential, frequently involving lymph nodes and the liver, even in well-differentiated stages.

Purpose Of The Study

  • To summarize the clinical course and treatment strategies for gastroenteropancreatic neuroendocrine neoplasms.
  • To highlight the prognostic implications of tumor differentiation and metastatic spread.
  • To discuss current therapeutic options for advanced or unresectable GEP-NENs.

Main Methods

  • Review of existing literature on GEP-NENs, focusing on disease characteristics, metastasis patterns, and treatment outcomes.
  • Analysis of surgical resection criteria (R0) and their impact on patient prognosis.
  • Evaluation of the role of systemic therapies, including somatostatin analogues, tyrosine kinase inhibitors, peptide receptor radionuclide therapy (PRRT), and liver-directed procedures.

Main Results

  • Surgical R0 resection, including removal of all metastatic sites (lymph nodes, liver), leads to excellent prognoses.
  • Diffuse liver or bone metastases often preclude curative surgical options.
  • Advanced GEP-NENs can be managed with systemic drugs, PRRT, and liver-directed interventions, enabling long-term survival with good quality of life.

Conclusions

  • Early detection and complete surgical resection are crucial for optimal outcomes in GEP-NENs.
  • Multimodal treatment approaches are essential for managing metastatic or unresectable GEP-NENs.
  • Modern therapies significantly improve long-term survival and quality of life for patients with advanced GEP-NENs.

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