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Assessment of Response to Treatment and Follow-Up in Gastroenteropancreatic Neuroendocrine Neoplasms

[ Vol. 18 , Issue. 5 ]

Author(s):

Franco Grimaldi*, Nicola Fazio, Roberto Attanasio, Andrea Frasoldati, Enrico Papini, Nadia Cremonini, Mariavittoria Davi, Luigi Funicelli, Sara Massironi, Francesca Spada, Vincenzo Toscano, Annibale Versari, Michele Zini, Massimo Falconi and Kjell Oberg   Pages 419 - 449 ( 31 )

Abstract:


Well-established criteria for evaluating the response to treatment and the appropriate followup of individual patients are critical in clinical oncology. The current evidence-based data on these issues in terms of the management of gastroenteropancreatic (GEP) neuroendocrine neoplasms (NEN) are unfortunately limited.

This document by the Italian Association of Clinical Endocrinologists (AME) on the criteria for the follow-up of GEP-NEN patients is aimed at providing comprehensive recommendations for everyday clinical practice based on both the best available evidence and the combined opinion of an interdisciplinary panel of experts.

The initial risk stratification of patients with NENs should be performed according to the grading, staging and functional status of the neoplasm and the presence of an inherited syndrome. The evaluation of response to the initial treatment, and to the subsequent therapies for disease progression or recurrence, should be based on a cost-effective, risk-effective and timely use of the appropriate diagnostic resources.

A multidisciplinary evaluation of the response to the treatment is strongly recommended and, at every step in the follow-up, it is mandatory to assess the disease state and the patient performance status, comorbidities, and recent clinical evolution.

Local expertise, available technical resources and the patient preferences should always be evaluated while planning the individual clinical management of GEP-NENs.

Keywords:

Neuroendocrine tumors, NET follow-up, criteria of response, markers, imaging, non-functioning NET, carcinoid syndrome, gastrinoma, insulinoma, NEN.

Affiliation:

Azienda Sanitaria Universitaria Integrata di Udine - Endocrinology and Metabolic Disease Unit Udine, European Institute of Oncology - Gastrointestinal Medical Oncology and NET Unit Milan, Istituto Galeazzi IRCCS - Endocrinology Milan, Azienda Ospedaliera S. Maria Nuova IRCCS - Endocrinology Unit Reggio Emilia, Regina Apostolorum Hospital - Endocrinology and Metabolic Diseases Albano Laziale (RM), Clinica Villalba - Endocrinology Clinics Bologna, Azienda Ospedaliera Universitaria Integrata - Section of Endocrinology, Medicina Generale e Malattie Aterotrombotiche e Degenerative Verona, European Institute of Oncology - Radiology Milan, Fondazione IRCCS Ca` Granda, Ospedale Maggiore Policlinico - Gastroenterology and Endoscopy Unit Milan, European Institute of Oncology - Gastrointestinal Medical Oncology and NET Unit Milan, Sant`Andrea Hospital, Sapienza University of Rome - Endocrinology, Department of Clinical and Molecular Medicine Rome, Azienda Ospedaliera S. Maria Nuova IRCCS - Nuclear Medicine Unit Reggio Emilia, Azienda Ospedaliera S. Maria Nuova IRCCS - Endocrinology Unit Reggio Emilia, San Raffaele Scientific Institute, Vita e Salute University - Division of Pancreatic Surgery, Pancreas Translational and Clinical Research Center Milan, University Hospital - Endocrine Oncology Uppsala



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