ABSTRACT
Gastroenteropancreatic neuroendocrine neoplasms (GEP-NENs) are highly heterogeneous tumors. According to the 2019 World Health Organization classification and grading criteria for neuroendocrine neoplasms of the gastrointestinal tract and hepatopancreatobiliary organs, GEP-NENs include well-differentiated neuroendocrine tumors (NETs), poorly differentiated neuroendocrine carcinomas (NECs), and mixed neuroendocrine-non-neuroendocrine neoplasms (MiNENs). GEP-NETs may present as hormonally functioning or nonfunctioning tumors and may have distinct clinical features based on their sites of origin. The Expert Committee of Neuroendocrine Tumors, Chinese Society of Clinical Oncology revised and updated the 2016 version of Chinese expert consensus on GEP-NENs. The update the consensus includes the epidemiology, clinical manifestations, biochemical and imaging examinations, pathological features, and treatment and follow-up of GEP-NENs.
Subject(s)
Humans , Consensus , Intestinal Neoplasms/therapy , Neuroendocrine Tumors/pathology , Pancreatic Neoplasms/pathology , Stomach Neoplasms/pathology , ChinaABSTRACT
With the increase in the incidence of gastrointestinal neuroendocrine tumors(GEP-NETs),the treatment for gastrointestinal neuroendocrine tumors is gaining more attention.According to the fourth edition of the World Health Organization(WHO)digestive system tumors pathological classification in 2010,the neuroendocrine tumors can be divided into 3 levels:G1,G2,and G3,respective-ly.Among them,the G1 and G2 level are neuroendocrine tumors,G3 level is neuroendocrine carcinoma.For G1 and G2 level tumors, existing medicine treatments include somatostatin analogs,chemotherapy,targeted therapy,and interferons;while for G3 level neuro-endocrine carcinoma,platinum-based chemotherapy is generally prioritized.Recent studies have found that immune factors also con-tribute to neuroendocrine tumors.Clinical trials on immunotherapy of neuroendocrine tumors are ongoing.In this paper,the drug treatments for GEP-NETs are briefly described.
ABSTRACT
Objective To investigate the safety,effectiveness and prognosis of percutaneous microwave ablation (MWA) combined with synchronous transarterial chemoembolization (TACE) to treat of gastroenteropancreatic neuroendocrine neoplasms (GEP-NENs) with liver metastases (LMs).Methods This retrospective study included 19 cases of GEP-NENs with LMs patients who received percutaneous MWA combined with synchronous TACE treatment from 2013 to 2016.The mRECIST standard was selected to assess the curative effect.SPSS 21.0 software was applied in the statistical analysis of overall survival (OS),progression-free survival (PFS) and factors related to prognosis.Results All patients were capable of curative effect evaluation,including 1 case of complete remission (CR),3 cases of partial remission (PR),7 cases of progressive disease (PD) and 8 cases of stable disease (SD) respectively accounting for 5 ％,16 ％,37 ％,42 ％,which exhibited 21％ of response rate (RR) and 63％ disease control rate (DCR).In the present study,the median OS and median PFS was respectively 25 months and 34 months,and the one-year survival and three-year survival was respectively 95％ and 84％.Serum CA199,the WHO classification of LMs and the tumor burden of LMs were the major risk factors of prognosis through single factor analysis of survival,which showed that G3 of the WHO classification of LMs predicted a poor OS (P＜0.05) and tumor burden of LMs was negatively related to PFS (P＜0.05).It was obviously observed that serum CgA was decreased by the therapy of percutaneous MWA with synchronous TACEfor GEP-NENs (P＜0.05).Conclusions Percutaneous MWA combined with synchronous TACE is a safe and effective method to treat GEP-NENs with LMs.