29Nov 2023 by Ronny Allan No Comments
European Neuroendocrine Tumor Society (ENETS) 2023 guidance paper for Digestive Neuroendocrine Carcinoma

European Neuroendocrine Tumor Society (ENETS) 2023 guidance paper for Digestive Neuroendocrine Carcinoma

Latest ENETS Guidelines
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…
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14Nov 2023 by Ronny Allan No Comments
European Neuroendocrine Tumor Society (ENETS) 2023 guidance paper for gastric neuroendocrine tumours (NETs) G1–G3

European Neuroendocrine Tumor Society (ENETS) 2023 guidance paper for gastric neuroendocrine tumours (NETs) G1–G3

Latest ENETS Guidelines
The ENETS 2023 guideline for gNETs are combined with the guidelines for Duodenal NET (dNET) due to their close relationship in anatomical terms. Gastric neuroendocrine neoplasms (gNENs) are tumours with an increasing annual incidence and.  The vast majority of gNENs are well-differentiated neuroendrocrine tumours (NETs), which are usually classified according to the background gastric pathology into three major categories known as "types" - these should not be confused with "grades" which are generated by histopathological tissue sampling (biopsy). Type I when chronic atrophic gastritis (CAG) is present resulting in hypergastrinaemia (high Gastrin) and high gastric pH. They are the most common type, accounting for 75%–80% of all gNENs. Type I gNETs are normally 'indolent' with negligible risk of metastases (<5%) and excellent long-term survival (almost 100%). Type II when the tumour occurs due…
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13Nov 2023 by Ronny Allan 1 Comment
European Neuroendocrine Tumor Society (ENETS) 2023 guidance paper for Duodenal neuroendocrine tumours (NETs) G1–G3

European Neuroendocrine Tumor Society (ENETS) 2023 guidance paper for Duodenal neuroendocrine tumours (NETs) G1–G3

Latest ENETS Guidelines
The ENETS 2023 guideline for dNETs are combined with the guidelines for Gastric NET (gNET) due to their close relationship in anatomical terms.  But there are functional linkages to the pancreas, therefore also links to that as above. The duodenum is technically part of the small intestine, and you can find that in most anatomy-based descriptions. One of the research references I used was titled “Somewhere between the pancreas and the small intestine” and in the case of Duodenal NENs (dNENs), I can understand why they adopted that unconventional anatomy description.  I suspect they contextually meant that they are not like either of these organs, but they share some similarities.  This seems at odds with the ENETs decision to link guidelines for stomach and duodenal in one. They are not…
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29Oct 2023 by Ronny Allan 2 Comments
European Neuroendocrine Tumor Society 2023 guidance paper for functioning pancreatic neuroendocrine tumour syndromes

European Neuroendocrine Tumor Society 2023 guidance paper for functioning pancreatic neuroendocrine tumour syndromes

Latest ENETS Guidelines
There is very much a multi-disciplinary team (MDT) approach to treating Neuroendocrine Tumours (NET) in Europe and many other places.  In Europe and the extra-Europe CoEs in Australia, Israel and the USA, this is centred on the establishment of the Centre of Excellence programme that has been running since 2009.  But underneath that are some excellent MDTs not yet accredited who may still utilise ENETs guidelines to treat and manage their patients. This 2023 guideline paper sets the scene for an important and complex group of tumours - pancreatic NETs.  It's well known and accepted that the minority of pancreatic NETs are nonfunctional, depending on where you look, anything between 50 and 85%. This means functional pancreatic NETs are less common than nonfunctional. The reason for emphasis is that patient support…
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28Oct 2023 by Ronny Allan 2 Comments
European Neuroendocrine Tumour Society (ENETS) 2023 guidance paper for nonfunctioning pancreatic neuroendocrine tumours

European Neuroendocrine Tumour Society (ENETS) 2023 guidance paper for nonfunctioning pancreatic neuroendocrine tumours

Latest ENETS Guidelines
There is very much a multi-disciplinary team (MDT) approach to treating Neuroendocrine Tumours (NET) in Europe and many other places.  In Europe and the extra-Europe CoEs in Australia, Israel and the USA, this is centred on the establishment of the Centre of Excellence programme that has been running since 2009.  But underneath that are some excellent MDTs not yet accredited who may still utilise ENETs guidelines to treat and manage their patients. This 2023 guideline paper sets the scene for an important and complex group of tumours - pancreatic NETs.  It's well known and accepted that the majority of pancreatic NETs are non-functional, depending on where you look, anything between 50 and 85%. “Non-functional” means that the tumour doesn’t produce a sufficient set of symptoms to cause a hormonal syndrome.While the…
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