This ENETS guidance paper, developed by a multidisciplinary working group, provides up-to-date and practical advice on the diagnosis and management of digestive neuroendocrine carcinoma, based on recent developments and study results. These recommendations aim to pave the road for more standardized care for our patients resulting in improved outcomes. However, it’s true to say that the prognosis for differentiated Neuroendocrine Carcinomas (NEC) is generally poorer than the less aggressive Neuroendocrine Tumours (NET).
Surgery can be of benefit for localized disease after extensive preoperative imaging. Carboplatin in combination with etoposide is recommended as first-line treatment for metastatic disease. Irinotecan with fluoropyrimidines has the best evidence as second-line treatment. Immunotherapy plays a minor role in biomarker-unselected patients. Molecular profiling if available is encouraged to identify new targets. More prospective clinical trials are highly needed to fulfil the unmet needs in this field, especially on new predictive and prognostic biomarkers and to improve survival of patients with advanced disease.
Given the naming of the WHO Classification of Tumours publications (pending the forthcoming 2022 wide scope publication), the term “digestive” might be confusing to some but I can confirm it includes the gastrointestinal tract plus pancreatic NECs effectively making it a Gastroenteropancreatic (GEP) NEC guidance document.
Q1 – What clinical examinations for diagnosis and staging should be performed in a newly diagnosed digestive NEC?
Q2 – What pathological workup is needed for a newly diagnosed digestive NEC?
Q3 – What are the prognosis and prognostic factors for digestive NEC?
Q4 – How should surgery, chemoradiation and neoadjuvant chemotherapy be used in localized (stage I–III) digestive NEC?
Q5 – Should adjuvant chemotherapy be given for localized (stage I–III) digestive NEC?
Q6 – What should be given as first-line treatment for metastatic digestive NEC?
Q7 – What should be given as second- and third-line treatment for metastatic digestive NEC
Q8 – Should immunotherapy (immune checkpoint inhibitors) be used for treatment of digestive NEC?
Q9 – Is molecular/genetic based therapy an option for digestive NEC?
Q10 – How should high-grade digestive MiNEN be diagnosed and treated?
Now read the reference material on Digestive Neuroendocrine Carcinoma below
Click on the blue link below see read the discussion and the recommendations for each of those questions.
Sorbye H, Grande E, Pavel M, Tesselaar M, Fazio N, Reed NS, Knigge U, Christ E, Ambrosini V, Couvelard A, Tiensuu Janson E. European Neuroendocrine Tumor Society (ENETS) 2023 guidance paper for digestive neuroendocrine carcinoma. J Neuroendocrinol. 2023 Mar;35(3):e13249. doi: 10.1111/jne.13249. Epub 2023 Mar 16. PMID: 36924180.
I am not a doctor or any form of medical professional, practitioner or counsellor. None of the information on my website, or linked to my website(s), or conveyed by me on any social media or presentation, should be interpreted as medical advice given or advised by me.
Neither should any post or comment made by a follower or member of my private group be assumed to be medical advice, even if that person is a healthcare professional. Some content may be generated by AI which can sometimes be misinterpreted. Please check any references attached.
Please also note that mention of a clinical service, trial/study or therapy does not constitute an endorsement of that service, trial/study or therapy by Ronny Allan, the information is provided for education and awareness purposes and/or related to Ronny Allan’s own patient experience. This element of the disclaimer includes any complementary medicine, non-prescription over the counter drugs and supplements such as vitamins and minerals.
Thanks for reading.
Blog Facebook. Like this page please.
Personal Facebook. Like this page please.
Awareness Facebook Like this page please.
Follow me on X (formerly twitter)
Check out my online presentations
Check out my WEGO Health Awards
A monthly update not to miss…….. Summary of April 2026 on RonnyAllan.NET I think the main story of April is similar to March which was a
DisclaimerThis Spotlight is for general education and reassurance only. It cannot replace personalised advice from your own medical team, who understand your individual history, imaging,
DisclaimerThe information in this Spotlight is for general education only. It cannot replace advice from your own medical team, who know your individual situation, test
I was delighted to read about the efforts of Dr Arthur Scott, a Member of the UK Parliament (MP). He is a great advocate for
DisclaimerThis information is for education and reassurance only.It is not a substitute for personalised medical advice, diagnosis, or treatment. Bone metastases in neuroendocrine tumours (NETs)
Before you read thisThis information is designed to help you understand how vitamins work in the body and how certain NET-related factors might affect them.
Here is my monthly summary of March 2026 on RonnyAllan.NET This has been a very good month but to be honest, I had more time at
Before you read this… This article discusses pathology concepts such as Ki-67, grading, heterogeneity, and biopsy findings in neuroendocrine tumours (NETs). It is provided for
Before you read this… This article is provided to support understanding of a complex and evolving topic. It explains how liver transplant is being explored
I would also mention those who contributed to my “Tea Fund” which resides on PayPal. You don’t need a PayPal account as you can select a card but don’t forget to select the number of units first (i.e. 1 = £4, 2 = £8, 3 = £12, and so on), plus further on, tick a button to NOT create a PayPal account if you don’t need one. Clearly, if you have a PayPal account, the process is much simpler
Through your generosity, I am able to keep my sites running and provide various services for you. I have some ideas for 2023 but they are not detailed enough to make announcements yet.
This screenshot is from every single post on my website and depending on which machine you are using, it will either be top right of the post or at the bottom (my posts are often long, so scroll down!)
Subscribe to get the latest posts sent to your email.
