Clinical management of typical and atypical carcinoids/neuroendocrine tumors in ENETS centres of excellence (CoE): Survey from the ENETS lung NET task force

Continuing with the output of updated clinical guidelines from ENETS, this paper is unlike the others so far in 2022/23/24 where the guidelines were set against several clinical questions for particular scenarios (presumably common in the NET patient population). So far, the clinical guidelines have centred on Gastroenteropancreatic Neuroendocrine Neoplasms (GEP NENs) (Neuroendocrine Carcinoma (NEC) and Neuroendocrine Tumours (NET)).

The latest output comes in a different format than the GEP NEN output but is based on Lung NETs, i.e. well differentiated Lung NETs. I’m hoping it is a precursor to a set of updated Lung NEN guidelines. Although, as you will see there is no well differentiated grade 3 but a special category of well differentiated Lung NET with aggressive features. The Lung WHO 2021 classification of tumours (see Spotlight on Lung NENs) covered this special category (putting it into the large cell Lung NEC category as a placeholder). The same reference also failed to remove the ‘carcinoid‘ misnomer word, so my apologies for the use of this term in the attached reference link and in this post. However, still good to see output for Lung NETs. Worth pointing out that many Lung NEC are handled by Lung Multidisciplinary Teams (MDT), a slightly controversial point, particularly when the statistics for these Neuroendocrine Carcinomas (particularly small cell lung cancer (SCLC) are not included in overall NEN statistical data.

The format is based on a survey completed by thirty-four experts from 20 centres specialising in lung NET (I will in due course update my ‘Find a NET expert‘ section to incorporate this useful data).

Clinical questions

Q1 and Q2 collected information about the medical specialist responding to the survey, who is the first point of contact for the patient, and the structure of the centre (type of structure, lung NET dedicated MDTB, number of lung NET dealing per year, and number of new lung NET dealing per year; details are shown in Table 1).

Q3 and Q4 focused on the diagnostic investigations for specific clinical cases with potentially resectable disease (a peripheral or a centrally located lung NET lesion).

Clinical case scenarios (Q5–11).

Adjuvant treatment (Q12–15)

Feasibility of conducting an adjuvant clinical trial (Q16–17)

Follow-up protocols (Q18–20)

Clinical cases (21, 22)

Now read the reference material below if you are interested in the output from this survey and the summarising information.

Reference

Click on the blue link below see read the discussion and the recommendations for each of those questions.

Clinical management of typical and atypical carcinoids/neuroendocrine tumors in ENETS centres of excellence (CoE): Survey from the ENETS lung NET task force

Anna Koumarianou , Pier Luigi Filosso , Lisa Bodei , Justo P. Castano , Lynnette Fernandez-Cuesta , Christophe M. Deroose , Matthieu Foll , Clarisse Dromain , Nicholas Simon Reed , Martyn Caplin , Jaume Capdevila , Jenny Falkerby , Antongiulio Faggiano , Andrea Frilling , Enrique Grande , Rodney J. Hicks , Atsuko Kasajima , Beata Kos-Kudla , B. A. Krishna , Eric Lim , Anja Rinke , Simron Singh , Chrissie Thirlwell , Marco Volante , Thomas Walter

First published: 16 May 2024https://doi.org/10.1111/jne.13412

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