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      ENETS Consensus Guidelines for High-Grade Gastroenteropancreatic Neuroendocrine Tumors and Neuroendocrine Carcinomas

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          ENETS Consensus Guidelines Update for the Management of Patients with Functional Pancreatic Neuroendocrine Tumors and Non-Functional Pancreatic Neuroendocrine Tumors

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            ENETS Consensus Guidelines Update for the Management of Distant Metastatic Disease of Intestinal, Pancreatic, Bronchial Neuroendocrine Neoplasms (NEN) and NEN of Unknown Primary Site

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              Predictive and prognostic factors for treatment and survival in 305 patients with advanced gastrointestinal neuroendocrine carcinoma (WHO G3): the NORDIC NEC study.

              As studies on gastrointestinal neuroendocrine carcinoma (WHO G3) (GI-NEC) are limited, we reviewed clinical data to identify predictive and prognostic markers for advanced GI-NEC patients. Data from advanced GI-NEC patients diagnosed 2000-2009 were retrospectively registered at 12 Nordic hospitals. The median survival was 11 months in 252 patients given palliative chemotherapy and 1 month in 53 patients receiving best supportive care (BSC) only. The response rate to first-line chemotherapy was 31% and 33% had stable disease. Ki-67<55% was by receiver operating characteristic analysis the best cut-off value concerning correlation to the response rate. Patients with Ki-67<55% had a lower response rate (15% versus 42%, P<0.001), but better survival than patients with Ki-67≥55% (14 versus 10 months, P<0.001). Platinum schedule did not affect the response rate or survival. The most important negative prognostic factors for survival were poor performance status (PS), primary colorectal tumors and elevated platelets or lactate dehydrogenase (LDH) levels. Advanced GI-NEC patients should be considered for chemotherapy treatment without delay.PS, colorectal primary and elevated platelets and LDH levels were prognostic factors for survival. Patients with Ki-67<55% were less responsive to platinum-based chemotherapy, but had a longer survival. Our data indicate that it may not be correct to consider all GI-NEC as one single disease entity.
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                Author and article information

                Journal
                NEN
                Neuroendocrinology
                10.1159/issn.0028-3835
                Neuroendocrinology
                S. Karger AG
                978-3-318-05841-3
                978-3-318-05842-0
                0028-3835
                1423-0194
                2016
                April 2016
                05 January 2016
                : 103
                : 2
                : 186-194
                Affiliations
                aMedical Oncology Department, Hospital Universitario Doce de Octubre, Madrid, Spain; bDepartment of Oncology, Haukeland University Hospital, Bergen, Norway; cInstitut Gustave Roussy, Villejuif, and dOncologie Médicale, Hôpitaux Universitaires Paris Nord Val de Seine, Paris, France; eDepartment of Hepatology and Gastroenterology, Campus Virchow Klinikum, Charité Universitätsmedizin Berlin, Berlin, Germany; fDepartment of Surgery, Medical University of Vienna, Vienna, Austria; gDepartment of Oncology, First Faculty of Medicine and General Teaching Hospital, Prague, Czech Republic; hNeuroendocrine Tumour Unit, Royal Free Hospital, London, UK; iInstitut für Pathologie und Zytologie, St. Vincenz Krankenhaus, Limburg, Germany; jDepartment of Radiology, Faculty of Medical Sciences, University of Warmia and Mazury, Olsztyn, Poland; kNeuroendocrine Tumour Unit, Royal Free Hospital, London, UK; lNET Centre, St. Vincent's University and Department of Clinical Medicine, St. James Hospital and Trinity College, Dublin, Ireland; mInstitute of Pathology, University of Bern, Bern, Switzerland
                Author notes
                *Dr. Rocio Garcia-Carbonero, Medical Oncology Department, Hospital Universitario Doce de Octubre, Avenida de Cordoba km 5.4, ES-28041 Madrid (Spain), E-Mail rgcarbonero@gmail.com
                Author information
                https://orcid.org/0000-0002-6819-6092
                Article
                443172 Neuroendocrinology 2016;103:186-194
                10.1159/000443172
                26731334
                b46b6cc9-b79d-4fcd-a06c-bd3c1b59b645
                © 2016 S. Karger AG, Basel

                Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

                History
                Page count
                Figures: 2, Tables: 1, References: 52, Pages: 9
                Categories
                ENETS Consensus Guidelines

                Endocrinology & Diabetes,Neurology,Nutrition & Dietetics,Sexual medicine,Internal medicine,Pharmacology & Pharmaceutical medicine

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