nach oben

Erschienen in:

01.08.2015 | Endocrine Tumors

Consensus Recommendations for the Diagnosis and Management of Pancreatic Neuroendocrine Tumors: Guidelines from a Canadian National Expert Group

verfasst von: Simron Singh, MD, MPH, Chris Dey, MD, Hagen Kennecke, MD, Walter Kocha, MD, Jean Maroun, MD, Peter Metrakos, MD, Tariq Mukhtar, PhD, Janice Pasieka, MD, Daniel Rayson, MD, Corwyn Rowsell, MD, Lucas Sideris, MD, Ralph Wong, MD, Calvin Law, MD

Erschienen in: Annals of Surgical Oncology | Ausgabe 8/2015

Einloggen, um Zugang zu erhalten

Abstract

Pancreatic neuroendocrine tumors (pNETs) are rare heterogeneous tumors that have been steadily increasing in both incidence and prevalence during the past few decades. Pancreatic NETs are categorized as functional (F) or nonfunctional (NF) based on their ability to secrete hormones that elicit clinically relevant symptoms. Specialized diagnostic tests are required for diagnosis. Treatment options are diverse and include surgical resection, intraarterial hepatic therapy, and peptide receptor radionuclide therapy (PRRT). Systemic therapy options include targeted agents as well as chemotherapy when indicated. Diagnosis and management should occur through a collaborative team of health care practitioners well-experienced in managing pNETs. Recent advances in pNET treatment options have led to the development of the Canadian consensus document described in this report. The discussion includes the epidemiology, classification, pathology, clinical presentation and prognosis, imaging and laboratory testing, medical and surgical management, and recommended treatment algorithms for pancreatic neuroendocrine cancers.

Kocha W, Maroun J, Kennecke H, et al. Consensus recommendations for the diagnosis and management of well-differentiated gastroenterohepatic neuroendocrine tumours: a revised statement from a Canadian National Expert Group. Curr Oncol. 2010;17:49–64.PubMedCentralPubMedCrossRef

Metz DC, Jensen RT. Gastrointestinal neuroendocrine tumors: pancreatic endocrine tumors. Gastroenterology. 2008;135:1469–92. doi:10.1053/j.gastro.2008.05.047.PubMedCentralPubMedCrossRef

Ellison TA, Edil BH. The current management of pancreatic neuroendocrine tumors. Adv Surg 2012;46:283–96.PubMedCrossRef

Strosberg JR, Cheema A, Weber J, Han G, Coppola D, Kvols LK. Prognostic validity of a novel American Joint Committee on Cancer Staging Classification for pancreatic neuroendocrine tumors. J Clin Oncol. 2011;29:3044–9. doi:10.1200/JCO.2011.35.1817 PubMedCrossRef

Massironi S, Sciola V, Peracchi M, Ciafardini C, Spampatti MP, Conte D. Neuroendocrine tumors of the gastro-entero-pancreatic system. World J Gastroenterol. 2008;14:5377–84.PubMedCentralPubMedCrossRef

Jensen RT, Cadiot G, Brandi ML, et al. ENETS Consensus guidelines for the management of patients with digestive neuroendocrine neoplasms: functional pancreatic endocrine tumor syndromes. Neuroendocrinology. 2012;95:98–119. doi:10.1159/000335591.PubMedCentralPubMedCrossRef

Kulke MH, Benson AB III, Bergsland E, et al. Neuroendocrine tumors. J Natl Compr Canc Netw. 2012;10:724–64.

O’Toole D, Salazar R, Falconi M, et al. Rare functioning pancreatic endocrine tumors. Neuroendocrinology. 2006;84:189–95. doi:10.1159/000098011.PubMedCrossRef

Falconi M, Plockinger U, Kwekkeboom DJ, et al. Well-differentiated pancreatic nonfunctioning tumors/carcinoma. Neuroendocrinology. 2006;84:196–211. doi:10.1159/000098012.PubMedCrossRef

10.

Yao JC, Hassan M, Phan A, et al. One hundred years after “carcinoid”: epidemiology of and prognostic factors for neuroendocrine tumors in 35,825 cases in the United States. J Clin Oncol. 2008;26:3063–3072. doi:10.1200/JCO.2007.15.4377.PubMedCrossRef

11.

Halfdanarson TR, Rabe KG, Rubin J, Petersen GM. Pancreatic neuroendocrine tumors (PNETs): incidence, prognosis, and recent trend toward improved survival. Ann Oncol. 2008;19:1727–33. doi:10.1093/annonc/mdn351.PubMedCentralPubMedCrossRef

12.

Cukier M, Law C, Liu N, et al. Epidemiology and survival of neuroendocrine tumors in Ontario: a 15-year population-based study [abstract]. J Clin Oncol. 2012;30.

13.

Klimstra DS, Modlin IR, Coppola D, Lloyd RV, Suster S. The pathologic classification of neuroendocrine tumors: a review of nomenclature, grading, and staging systems. Pancreas. 2010;39:707–12. doi:10.1097/MPA.0b013e3181ec124e.PubMedCrossRef

14.

Bosman T, Carneiro F, Hruban R, Theise N. WHO Classification of Tumours of the Digestive System. 4th ed. Lyon: IARC Press; 2010. pp. 13–14.

15.

Edge SB, Byrd DR, Compton CC, Fritz AG, Greene FL, Trotti A (eds). AJCC Cancer Staging Manual. 7th ed. New York: Springer; 2010.

16.

Rindi G, Kloppel G, Alhman H, et al. TNM staging of foregut (neuro)endocrine tumors: a consensus proposal including a grading system. Virchows Arch. 2006;449:395–401. doi:10.1007/s00428-006-0250-1.PubMedCentralPubMedCrossRef

17.

Rindi G, Kloppel G, Couvelard A, et al. TNM staging of midgut and hindgut (neuro) endocrine tumors: a consensus proposal including a grading system. Virchows Arch. 2007;451:757–62. doi:10.1007/s00428-007-0452-1.PubMedCrossRef

18.

Tang L, Berlin J, Branton P, et al. Protocol for the examination of specimens from patients with carcinoma of the endocrine pancreas. College of American Pathologists (CAP); 2013. Pancreas Endocrine 3.2.0.1.

19.

Chejfec G, Falkmer S, Grimelius L, et al. Synaptophysin: a new marker for pancreatic neuroendocrine tumors. Am J Surg Pathol. 1987;11:241–7.PubMedCrossRef

20.

Modlin IM, Gustafsson BI, Moss SF, Pavel M, Tsolakis AV, Kidd M. Chromogranin A: biological function and clinical utility in neuro endocrine tumor disease. Ann Surg Oncol. 2010;17:2427–43. doi:10.1245/s10434-010-1006-3.PubMedCrossRef

21.

Taupenot L, Harper KL, O’Connor DT. The chromogranin-secretogranin family. N Engl J Med. 2003;348:1134–49. doi:10.1056/NEJMra021405.PubMedCrossRef

22.

Wiedenmann B, Franke WW, Kuhn C, Moll R, Gould VE. Synaptophysin: a marker protein for neuroendocrine cells and neoplasms. Proc Natl Acad Sci U S A. 1986;83:3500–4.PubMedCentralPubMedCrossRef

23.

Bridger JM, Kill IR, Lichter P. Association of pKi-67 with satellite DNA of the human genome in early G1 cells. Chromosome Res. 1998;6:13–24.PubMedCrossRef

24.

Bruno S, Darzynkiewicz Z. Cell cycle dependent expression and stability of the nuclear protein detected by Ki-67 antibody in HL-60 cells. Cell Prolif. 1992;25:31–40.PubMedCrossRef

25.

Endl E, Gerdes J. The Ki-67 protein: fascinating forms and an unknown function. Exp Cell Res. 2000;257:231–7. doi:10.1006/excr.2000.4888.PubMedCrossRef

26.

Scholzen T, Gerdes J. The Ki-67 protein: from the known and the unknown. J Cell Physiol. 2000;182:311–22. doi:10.1002/(SICI)1097-4652(200003)182:3<311::AID-JCP1>3.0.CO;2-9.

27.

Klimstra DS, Modlin IR, Adsay NV, et al. Pathology reporting of neuroendocrine tumors: application of the Delphic consensus process to the development of a minimum pathology data set. Am J Surg Pathol. 2010;34:300–13. doi:10.1097/PAS.0b013e3181ce1447.PubMedCrossRef

28.

Craig J, Cheung M, Law C, Singh S. Ki-67 index variability in neuroendocrine tumors [abstract]. EMSO. 2012; abstract 1158P 2012.

29.

Zerbi A, Falconi M, Rindi G, et al. Clinicopathological features of pancreatic endocrine tumors: a prospective multicenter study in Italy of 297 sporadic cases. Am J Gastroenterol. 2010;105:1421–9. doi:10.1038/ajg.2009.747.PubMedCrossRef

30.

Cheslyn-Curtis S, Sitaram V, Williamson RC. Management of nonfunctioning neuroendocrine tumours of the pancreas. Br J Surg. 1993;80:625–7.PubMedCrossRef

31.

Falconi M, Bartsch DK, Eriksson B, et al. ENETS Consensus guidelines for the management of patients with digestive neuroendocrine neoplasms of the digestive system: well-differentiated pancreatic nonfunctioning tumors. Neuroendocrinology. 2012;95:120–34. doi:10.1159/000335587.PubMedCrossRef

32.

White TJ, Edney JA, Thompson JS, Karrer FW, Moor BJ. Is there a prognostic difference between functional and nonfunctional islet cell tumors? Am J Surg. 1994;168:627–9.

33.

Bettini R, Partelli S, Boninsegna L, et al. Tumor size correlates with malignancy in nonfunctioning pancreatic endocrine tumor. Surgery. 2011;150:75–82. doi:10.1016/j.surg.2011.02.022.PubMedCrossRef

34.

Ekeblad S, Skogseid B, Dunder K, Oberg K, Eriksson B. Prognostic factors and survival in 324 patients with pancreatic endocrine tumor treated at a single institution. Clin Cancer Res. 2008;14:7798–803. doi:10.1158/1078-0432.CCR-08-0734.PubMedCrossRef

35.

Han JH, Kim MH, Moon SH, et al. Clinical characteristics and malignant predictive factors of pancreatic neuroendocrine tumors. Korean J Gastroenterol. 2009;53:98–105.

36.

La RS, Sessa F, Capella C, et al. Prognostic criteria in nonfunctioning pancreatic endocrine tumours. Virchows Arch. 1996;429:323–33.CrossRef

37.

Panzuto F, Nasoni S, Falconi M, et al. Prognostic factors and survival in endocrine tumor patients: comparison between gastrointestinal and pancreatic localization. Endocr Relat Cancer. 2005;12:1083–92. doi:10.1677/erc.1.01017.PubMedCrossRef

38.

Panzuto F, Boninsegna L, Fazio N, et al. Metastatic and locally advanced pancreatic endocrine carcinomas: analysis of factors associated with disease progression. J Clin Oncol. 2011;29:2372–7. doi:10.1200/JCO.2010.33.0688.PubMedCrossRef

39.

Singh S, et al. [Abstract] The role of Ki-67 in the prognosis and management of neuroendocrine (NET) patients in a multidisciplinary cancer center. Gastrointestinal Cancers Symposium, 2012; (suppl 4; abstr 184).

40.

Noone TC, Hosey J, Firat Z, Semelka RC. Imaging and localization of islet cell tumours of the pancreas on CT and MRI. Best Pract Res Clin Endocrinol Metab. 2005;19:195–211. doi:10.1016/j.beem.2004.11.013.PubMedCrossRef

41.

Rockall AG, Reznek RH. Imaging of neuroendocrine tumours (CT/MR/US). Best Pract Res Clin Endocrinol Metab. 2007;21:43–68. doi:10.1016/j.beem.2007.01.003.PubMedCrossRef

42.

Sundin A, Vullierme MP, Kaltsas G, Plockinger U. ENETS Consensus Guidelines for the Standards of Care in Neuroendocrine Tumors: radiological examinations. Neuroendocrinology. 2009;90:167–83. doi:10.1159/000184855.PubMedCrossRef

43.

Figueiredo FA, Giovannini M, Monges G, et al. Pancreatic endocrine tumors: a large single-center experience. Pancreas. 2009;38:936–40. doi:10.1097/MPA.0b013e3181b365db.PubMedCrossRef

44.

Jhala NC, Jhala DN, Chhieng DC, Eloubeidi MA, Eltoum IA. Endoscopic ultrasound-guided fine-needle aspiration: a cytopathologist’s perspective. Am J Clin Pathol. 2003;120:351–67. doi:10.1309/MFRF-J0XY-JLN8-NVDP.PubMedCrossRef

45.

Kocjan G. Fine-needle aspiration cytology of the pancreas: a guide to the diagnostic approach. Coll Antropol. 2010;34:749–56.PubMed

46.

Pais SA, Al-Haddad M, Mohamadnejad M, et al. EUS for pancreatic neuroendocrine tumors: a single-center, 11-year experience. Gastrointest Endosc. 2010;71:1185–93. doi:10.1016/j.gie.2009.12.006.PubMedCrossRef

47.

Teunissen JJ, Kwekkeboom DJ, Valkema R, Krenning EP. Nuclear medicine techniques for the imaging and treatment of neuroendocrine tumours. Endocr Relat Cancer. 2011;18(Suppl 1):S27–S51. doi:10.1530/ERC-10-0282.PubMedCrossRef

48.

Binderup T, Knigge U, Loft A, Federspiel B, Kjaer A. 18F-fluorodeoxyglucose positron emission tomography predicts survival of patients with neuroendocrine tumors. Clin Cancer Res. 2010;16:978–85. doi:10.1158/1078-0432.CCR-09-1759.CrossRef

49.

Vinik AI, Woltering EA, Warner RR, et al. NANETS consensus guidelines for the diagnosis of neuroendocrine tumor. Pancreas. 2010;39:713–34. doi:10.1097/MPA.0b013e3181ebaffd.PubMedCrossRef

50.

Krausz Y, Freedman N, Rubinstein R, et al. 68Ga-DOTA-NOC PET/CT imaging of neuroendocrine tumors: comparison with (1)(1)(1)In-DTPA-octreotide (OctreoScan(R)). Mol Imaging Biol. 2011;13:583–93. doi:10.1007/s11307-010-0374-1.PubMedCrossRef

51.

Rufini V, Calcagni ML, Baum RP. Imaging of neuroendocrine tumors. Semin Nucl Med. 2006;36:228–47. doi:10.1053/j.semnuclmed.2006.03.007.PubMedCrossRef

52.

Singh S, Law C. Chromogranin A: A sensitive biomarker for the detection and posttreatment monitoring of gastroenteropancreatic neuroendocrine tumors. Expert Rev Gastroenterol Hepatol. 2012;6:313–34. doi:10.1586/egh.12.15.PubMedCrossRef

53.

Yao JC, Pavel M, Phan AT, et al. Chromogranin A and neuron-specific enolase as prognostic markers in patients with advanced pNET treated with everolimus. J Clin Endocrinol Metab. 2011;96:3741–9. doi:10.1210/jc.2011-0666.PubMedCrossRef

54.

Oberg K. Circulating biomarkers in gastroenteropancreatic neuroendocrine tumours. Endocr Relat Cancer. 2011;18(Suppl 1):S17–S25. doi:10.1530/ERC-10-0280.PubMedCrossRef

55.

55.Panzuto F, Severi C, Cannizzaro R, et al. Utility of combined use of plasma levels of chromogranin A and pancreatic polypeptide in the diagnosis of gastrointestinal and pancreatic endocrine tumors. J Endocrinol Invest. 2004;27:6–11.PubMedCrossRef

56.

Raines D, Chester M, Diebold AE, et al. A prospective evaluation of the effect of chronic proton pump inhibitor use on plasma biomarker levels in humans. Pancreas. 2012;41:508–11. doi:10.1097/MPA.0b013e318243a0b6.PubMedCrossRef

57.

Rustagi S, Warner RR, Divino CM. Serum pancreastatin: the next predictive neuroendocrine tumor marker. J Surg Oncol. 2013;108:126–8. doi:10.1002/jso.23359.PubMedCrossRef

58.

Kvols LK, Brendtro KL. The North American Neuroendocrine Tumor Society (NANETS) guidelines: mission, goals, and process. Pancreas. 2010;39:705–6. doi:10.1097/MPA.0b013e3181eb7451.PubMedCrossRef

59.

Lee LC, Grant CS, Salomao DR, et al. Small, nonfunctioning, asymptomatic pancreatic neuroendocrine tumors (PNETs): role for nonoperative management. Surgery. 2012;152:965–74. doi:10.1016/j.surg.2012.08.038.PubMedCrossRef

60.

Libutti SK, Inabnet WB III. Force or stratagem? Surgery. 2012;152:975–6. doi:10.1016/j.surg.2012.08.061.PubMedCrossRef

61.

Crippa S, Bassi C, Salvia R, Falconi M, Butturini G, Pederzoli P. Enucleation of pancreatic neoplasms. Br J Surg. 2007;94:1254–9. doi:10.1002/bjs.5833.PubMedCrossRef

62.

Hellman P, Goretzki P, Simon D, Dotzenrath C, Roher HD. Therapeutic experience of 65 cases with organic hyperinsulinism. Langenbecks Arch Surg. 2000;385:329–36.PubMedCrossRef

63.

63.Park BJ, Alexander HR, Libutti SK, et al. Operative management of islet cell tumors arising in the head of the pancreas. Surgery. 1998;124:1056–61.PubMedCrossRef

64.

Rothmund M, Angelini L, Brunt LM, et al. Surgery for benign insulinoma: an international review. World J Surg. 1990;14:393–8.PubMedCrossRef

65.

Muller MW, Friess H, Kleeff J, et al. Is there still a role for total pancreatectomy? Ann Surg. 2007;246:966–74. doi:10.1097/SLA.0b013e31815c2ca3.PubMedCrossRef

66.

Smith JK, Ng SC, Hill JS, et al. Complications after pancreatectomy for neuroendocrine tumors: a national study. J Surg Res. 2010;163:63–8. doi:10.1016/j.jss.2010.04.017.PubMedCrossRef

67.

Abu HM, McPhail MJ, Zeidan BA, Jones CE, Johnson CD, Pearce NW. Aggressive multi-visceral pancreatic resections for locally advanced neuroendocrine tumours. is it worth it? JOP. 2009;10:276–9.

68.

Bonney GK, Gomez D, Rahman SH, et al. Results following surgical resection for malignant pancreatic neuroendocrine tumours: a single institutional experience. JOP. 2008;9:19–25.

69.

69.Chen H, Hardacre JM, Uzar A, Cameron JL, Choti MA. Isolated liver metastases from neuroendocrine tumors: does resection prolong survival? J Am Coll Surg. 1998;187:88–92.PubMedCrossRef

70.

Dousset B, Saint-Marc O, Pitre J, Soubrane O, Houssin D, Chapuis Y. Metastatic endocrine tumors: medical treatment, surgical resection, or liver transplantation. World J Surg. 1996;20:908–14.PubMedCrossRef

71.

Fendrich V, Langer P, Celik I, et al. An aggressive surgical approach leads to long-term survival in patients with pancreatic endocrine tumors. Ann Surg. 2006;244:845–51. doi:10.1097/01.sla.0000246951.21252.60.PubMedCentralPubMedCrossRef

72.

Hodul PJ, Strosberg JR, Kvols LK. Aggressive surgical resection in the management of pancreatic neuroendocrine tumors: when is it indicated? Cancer Control. 2008;15:314–21.PubMed

73.

Kleine M, Schrem H, Vondran FW, Krech T, Klempnauer J, Bektas H. Extended surgery for advanced pancreatic endocrine tumours. Br J Surg. 2012;99:88–94. doi:10.1002/bjs.7681.PubMedCrossRef

74.

Norton JA, Kivlen M, Li M, Schneider D, Chuter T, Jensen RT. Morbidity and mortality of aggressive resection in patients with advanced neuroendocrine tumors. Arch Surg. 2003;138:859–66. doi:10.1001/archsurg.138.8.859.PubMedCrossRef

75.

Sarmiento JM, Que FG, Grant CS, Thompson GB, Farnell MB, Nagorney DM. Concurrent resections of pancreatic islet cell cancers with synchronous hepatic metastases: outcomes of an aggressive approach. Surgery. 2002;132:976–82. doi:10.1067/msy.2002.128615.PubMedCrossRef

76.

Sasson AR, Hoffman JP, Ross EA, Kagan SA, Pingpank JF, Eisenberg BL. En bloc resection for locally advanced cancer of the pancreas: is it worthwhile? J Gastrointest Surg. 2002;6:147–57.PubMedCrossRef

77.

Bold RJ, Charnsangavej C, Cleary KR, et al. Major vascular resection as part of pancreaticoduodenectomy for cancer: radiologic, intraoperative, and pathologic analysis. J Gastrointest Surg. 1999;3:233–43.PubMedCrossRef

78.

Kouvaraki MA, Solorzano CC, Shapiro SE, et al. Surgical treatment of nonfunctioning pancreatic islet cell tumors. J Surg Oncol. 2005;89:170–85. doi:10.1002/jso.20178.PubMedCrossRef

79.

Tseng JF, Raut CP, Lee JE, et al. Pancreaticoduodenectomy with vascular resection: margin status and survival duration. J Gastrointest Surg. 2004;8:935–49. doi:10.1016/j.gassur.2004.09.046.PubMedCrossRef

80.

Cusati D, Zhang L, Harmsen WS, et al. Metastatic nonfunctioning pancreatic neuroendocrine carcinoma to liver: surgical treatment and outcomes. J Am Coll Surg. 2012;215:117–24. doi:10.1016/j.jamcollsurg.2012.05.002.PubMedCrossRef

81.

81.Chamberlain RS, Canes D, Brown KT, et al. Hepatic neuroendocrine metastases: does intervention alter outcomes? J Am Coll Surg. 2000;190:432–45.PubMedCrossRef

82.

Hung JS, Chang MC, Lee PH, Tien YW. Is surgery indicated for patients with symptomatic nonfunctioning pancreatic neuroendocrine tumor and unresectable hepatic metastases? World J Surg. 2007;31:2392–7. doi:10.1007/s00268-007-9264-3.PubMedCrossRef

83.

Saxena A, Chua TC, Perera M, Chu F, Morris DL. Surgical resection of hepatic metastases from neuroendocrine neoplasms: a systematic review. Surg Oncol. 2012;21:e131–41. doi:10.1016/j.suronc.2012.05.001.PubMedCrossRef

84.

Mayo SC, de Jong MC, Bloomston M, et al. Surgery versus intraarterial therapy for neuroendocrine liver metastasis: a multicenter international analysis. Ann Surg Oncol. 2011;18:3657–65. doi:10.1245/s10434-011-1832-y.PubMedCrossRef

85.

Elias D, Sideris L, Liberale G, et al. Surgical treatment of peritoneal carcinomatosis from well-differentiated digestive endocrine carcinomas. Surgery. 2005;137:411–6. doi:10.1016/j.surg.2004.11.007.PubMedCrossRef

86.

Elias D, David A, Sourrouille I, et al. Neuroendocrine carcinomas: optimal surgery of peritoneal metastases (and associated intraabdominal metastases). Surgery. 2014;155:5–12. doi:10.1016/j.surg.2013.05.030.PubMedCrossRef

87.

Kianmanesh R, Ruszniewski P, Rindi G, et al. ENETS consensus guidelines for the management of peritoneal carcinomatosis from neuroendocrine tumors. Neuroendocrinology. 2010;91:333–40. doi:10.1159/000286700.PubMedCrossRef

88.

Steinmuller T, Kianmanesh R, Falconi M, et al. Consensus guidelines for the management of patients with liver metastases from digestive (neuro)endocrine tumors: foregut, midgut, hindgut, and unknown primary. Neuroendocrinology. 2008;87:47–62. doi:10.1159/000111037.PubMedCrossRef

89.

Kulke MH, Bendell J, Kvols L, Picus J, Pommier R, Yao J. Evolving diagnostic and treatment strategies for pancreatic neuroendocrine tumors. J Hematol Oncol. 2011;4:29. doi:10.1186/1756-8722-4-29.PubMedCentralPubMedCrossRef

90.

Lewis MA, Hobday TJ. Treatment of neuroendocrine tumor liver metastases. Int J Hepatol. 2012;973–946. doi:10.1155/2012/973946.

91.

Moertel CG, Hanley JA, Johnson LA. Streptozocin alone compared with streptozocin plus fluorouracil in the treatment of advanced islet-cell carcinoma. N Engl J Med. 1980;303:1189–94. doi:10.1056/NEJM198011203032101.PubMedCrossRef

92.

Kouvaraki MA, Ajani JA, Hoff P, et al. Fluorouracil, doxorubicin, and streptozocin in the treatment of patients with locally advanced and metastatic pancreatic endocrine carcinomas. J Clin Oncol. 2004;22:4762–771. doi:10.1200/JCO.2004.04.024.PubMedCrossRef

93.

Moertel CG, Lefkopoulo M, Lipsitz S, Hahn RG, Klaassen D. Streptozocin-doxorubicin, streptozocin-fluorouracil or chlorozotocin in the treatment of advanced islet-cell carcinoma. N Engl J Med. 1992;326:519–23. doi:10.1056/NEJM199202203260804.PubMedCrossRef

94.

Strosberg JR, Fine RL, Choi J, et al. First-line chemotherapy with capecitabine and temozolomide in patients with metastatic pancreatic endocrine carcinomas. Cancer. 2011;117:268–75. doi:10.1002/cncr.25425.PubMedCrossRef

95.

Mitry E, Baudin E, Ducreux M, et al. Treatment of poorly differentiated neuroendocrine tumours with etoposide and cisplatin. Br J Cancer. 1999;81:1351–5. doi:10.1038/sj.bjc.6690325.PubMedCentralPubMedCrossRef

96.

Hainsworth JD, Spigel DR, Litchy S, Greco FA. Phase II trial of paclitaxel, carboplatin, and etoposide in advanced poorly differentiated neuroendocrine carcinoma: a Minnie Pearl Cancer Research Network Study. J Clin Oncol. 2006;24:3548–54. doi:10.1200/JCO.2005.05.0575.PubMedCrossRef

97.

Sorbye H, Wekin S, Langer S, et al. Ki-67 Proliferative Index Predicts Response to Chemotherapy and Survival in 252 Patients with High-Grade Gastrointestinal Neuroendocrine Carcinoma (WHO G3) (abstract). North American Neuroendocrine Society Symposium, Abstract C36 2012.

98.

Welin S, Sorbye H, Sebjornsen S, Knappskog S, Busch C, Oberg K. Clinical effect of temozolomide-based chemotherapy in poorly differentiated endocrine carcinoma after progression on first-line chemotherapy. Cancer. 2011;117:4617–22. doi:10.1002/cncr.26124.PubMedCrossRef

99.

Yao JC, Shah MH, Ito T, et al. Everolimus for advanced pancreatic neuroendocrine tumors. N Engl J Med. 2011;364:514–23. doi:10.1056/NEJMoa1009290.PubMedCentralPubMedCrossRef

100.

Raymond E, Dahan L, Raoul JL, et al. Sunitinib malate for the treatment of pancreatic neuroendocrine tumors. N Engl J Med. 2011;364:501–13. doi:10.1056/NEJMoa1003825.PubMedCrossRef

101.

101.Ricke J, Klose KJ, Mignon M, Oberg K, Wiedenmann B. Standardisation of imaging in neuroendocrine tumours: results of a European Delphi process. Eur J Radiol. 2001;37:8–17.PubMedCrossRef

102.

A randomized, double-blind, placebo-controlled study of lanreotide antiproliferative response in patients with gastroenteropancreatic neuroendocrine tumors (CLARINET). The European Cancer Congress; 2013.

103.

Kwekkeboom DJ, de Herder WW, Kam BL, et al. Treatment with the radiolabeled somatostatin analog [177 Lu-DOTA 0,Tyr3]octreotate: toxicity, efficacy, and survival. J Clin Oncol. 2008;26:2124–30. doi:10.1200/JCO.2007.15.2553.PubMedCrossRef

104.

Kwekkeboom DJ, Krenning EP, Lebtahi R, et al. ENETS Consensus Guidelines for the Standards of Care in Neuroendocrine Tumors: peptide receptor radionuclide therapy with radiolabeled somatostatin analogs. Neuroendocrinology. 2009;90:220–6. doi:10.1159/000225951.PubMedCrossRef

105.

Sowa-Staszczak A, Pach D, Stefanska A, et al. Can treatment using radiolabelled somatostatin analogue increase the survival rate in patients with nonfunctioning neuroendocrine pancreatic tumours? Nucl Med Rev Cent East Eur. 2011;14:73–8.PubMedCrossRef

106.

Villard L, Romer A, Marincek N, et al. Cohort study of somatostatin-based radiopeptide therapy with [(90)Y-DOTA]-TOC versus [(90)Y-DOTA]-TOC plus [(177)Lu-DOTA]-TOC in neuroendocrine cancers. J Clin Oncol. 2012;30:1100–6. doi:10.1200/JCO.2011.37.2151.PubMedCrossRef

107.

Gulenchyn KY, Yao X, Asa SL, Singh S, Law C. Radionuclide therapy in neuroendocrine tumours: a systematic review. Clin Oncol R Coll Radiol. 2012;24:294–308. doi:10.1016/j.clon.2011.12.003.PubMedCrossRef

108.

108.Arnold R, Rinke A, Klose KJ, et al. Octreotide versus octreotide plus interferon-alpha in endocrine gastroenteropancreatic tumors: a randomized trial. Clin Gastroenterol Hepatol. 2005;3:761–71.PubMedCrossRef

109.

Fjallskog ML, Sundin A, Westlin JE, Oberg K, Janson ET, Eriksson B. Treatment of malignant endocrine pancreatic tumors with a combination of alpha-interferon and somatostatin analogs. Med Oncol. 2002;19:35–42. doi:10.1385/MO:19:1:35.PubMedCrossRef

110.

Modlin IM, Oberg K, Chung DC, et al. Gastroenteropancreatic neuroendocrine tumours. Lancet Oncol. 2008;9:61–72. doi:10.1016/S1470-2045(07)70410-2.PubMedCrossRef

Titel: Consensus Recommendations for the Diagnosis and Management of Pancreatic Neuroendocrine Tumors: Guidelines from a Canadian National Expert Group
verfasst von: Simron Singh, MD, MPH
Chris Dey, MD
Hagen Kennecke, MD
Walter Kocha, MD
Jean Maroun, MD
Peter Metrakos, MD
Tariq Mukhtar, PhD
Janice Pasieka, MD
Daniel Rayson, MD
Corwyn Rowsell, MD
Lucas Sideris, MD
Ralph Wong, MD
Calvin Law, MD
Publikationsdatum: 01.08.2015
Verlag: Springer US
Erschienen in: Annals of Surgical Oncology / Ausgabe 8/2015
Print ISSN: 1068-9265
Elektronische ISSN: 1534-4681
DOI: https://doi.org/10.1245/s10434-014-4145-0

Neu im Fachgebiet Chirurgie

Häusliche Gewalt in der orthopädischen Notaufnahme oft nicht erkannt

28.05.2024 Häusliche Gewalt Nachrichten

In der Notaufnahme wird die Chance, Opfer von häuslicher Gewalt zu identifizieren, von Orthopäden und Orthopädinnen offenbar zu wenig genutzt. Darauf deuten die Ergebnisse einer Fragebogenstudie an der Sahlgrenska-Universität in Schweden hin.

Fehlerkultur in der Medizin – Offenheit zählt!

28.05.2024 Fehlerkultur Podcast

Darüber reden und aus Fehlern lernen, sollte das Motto in der Medizin lauten. Und zwar nicht nur im Sinne der Patientensicherheit. Eine negative Fehlerkultur kann auch die Behandelnden ernsthaft krank machen, warnt Prof. Dr. Reinhard Strametz. Ein Plädoyer und ein Leitfaden für den offenen Umgang mit kritischen Ereignissen in Medizin und Pflege.

Mehr Frauen im OP – weniger postoperative Komplikationen

21.05.2024 Allgemeine Chirurgie Nachrichten

Ein Frauenanteil von mindestens einem Drittel im ärztlichen Op.-Team war in einer großen retrospektiven Studie aus Kanada mit einer signifikanten Reduktion der postoperativen Morbidität assoziiert.

TAVI versus Klappenchirurgie: Neue Vergleichsstudie sorgt für Erstaunen

21.05.2024 TAVI Nachrichten

Bei schwerer Aortenstenose und obstruktiver KHK empfehlen die Leitlinien derzeit eine chirurgische Kombi-Behandlung aus Klappenersatz plus Bypass-OP. Diese Empfehlung wird allerdings jetzt durch eine aktuelle Studie infrage gestellt – mit überraschender Deutlichkeit.

Update Chirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Aktuelle BDC Leitlinien-Webinare

S3-Leitlinie „Diagnostik und Therapie des Karpaltunnelsyndroms“

Karpaltunnelsyndrom BDC Leitlinien Webinare

CME: 2 Punkte

Das Karpaltunnelsyndrom ist die häufigste Kompressionsneuropathie peripherer Nerven. Obwohl die Anamnese mit dem nächtlichen Einschlafen der Hand (Brachialgia parästhetica nocturna) sehr typisch ist, ist eine klinisch-neurologische Untersuchung und Elektroneurografie in manchen Fällen auch eine Neurosonografie erforderlich. Im Anfangsstadium sind konservative Maßnahmen (Handgelenksschiene, Ergotherapie) empfehlenswert. Bei nicht Ansprechen der konservativen Therapie oder Auftreten von neurologischen Ausfällen ist eine Dekompression des N. medianus am Karpaltunnel indiziert.

Prof. Dr. med. Gregor Antoniadis

S2e-Leitlinie „Distale Radiusfraktur“

Radiusfraktur BDC Leitlinien Webinare

CME: 2 Punkte

Das Webinar beschäftigt sich mit Fragen und Antworten zu Diagnostik und Klassifikation sowie Möglichkeiten des Ausschlusses von Zusatzverletzungen. Die Referenten erläutern, welche Frakturen konservativ behandelt werden können und wie. Das Webinar beantwortet die Frage nach aktuellen operativen Therapiekonzepten: Welcher Zugang, welches Osteosynthesematerial? Auf was muss bei der Nachbehandlung der distalen Radiusfraktur geachtet werden?

PD Dr. med. Oliver Pieske

Dr. med. Benjamin Meyknecht

S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“

Appendizitis BDC Leitlinien Webinare

CME: 2 Punkte

Inhalte des Webinars zur S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“ sind die Darstellung des Projektes und des Erstellungswegs zur S1-Leitlinie, die Erläuterung der klinischen Relevanz der Klassifikation EAES 2015, die wissenschaftliche Begründung der wichtigsten Empfehlungen und die Darstellung stadiengerechter Therapieoptionen.

Dr. med. Mihailo Andric

Live-Webinar "Urologie und Sexualmedizin in der Praxis"

Springer Medizin

Consensus Recommendations for the Diagnosis and Management of Pancreatic Neuroendocrine Tumors: Guidelines from a Canadian National Expert Group

Abstract

Neu im Fachgebiet Chirurgie

Häusliche Gewalt in der orthopädischen Notaufnahme oft nicht erkannt

Fehlerkultur in der Medizin – Offenheit zählt!

Mehr Frauen im OP – weniger postoperative Komplikationen

TAVI versus Klappenchirurgie: Neue Vergleichsstudie sorgt für Erstaunen

Update Chirurgie

Aktuelle BDC Leitlinien-Webinare

S3-Leitlinie „Diagnostik und Therapie des Karpaltunnelsyndroms“

S2e-Leitlinie „Distale Radiusfraktur“

S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“

Live-Webinar "Urologie und Sexualmedizin in der Praxis"

Springer Medizin

Abstract

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 8/2015

Serious Postoperative Complications Affect Early Recurrence After Cytoreductive Surgery and HIPEC for Colorectal Peritoneal Carcinomatosis

Severe Obesity Impacts Recurrence-Free Survival of Women with High-Risk Endometrial Cancer: Results of a French Multicenter Study

Intratumor Textural Heterogeneity on Pretreatment 18F-FDG PET Images Predicts Response and Survival After Chemoradiotherapy for Hypopharyngeal Cancer

Improved Survival with Anti-VEGF Therapy in the Treatment of Unresectable Appendiceal Epithelial Neoplasms

Pancreatic Resection Results in a Statewide Surgical Collaborative

Effect of Endometriosis on the Prognosis of Ovarian Clear Cell Carcinoma: A Two-Center Cohort Study and Meta-analysis

Update Chirurgie