PMID- 19942827
OWN - NLM
STAT- MEDLINE
DCOM- 20100503
LR  - 20141120
IS  - 1121-421X (Print)
IS  - 1121-421X (Linking)
VI  - 55
IP  - 4
DP  - 2009 Dec
TI  - Management of gastroentero-pancreatic neuroendocrine tumors (GEP-NETs).
PG  - 425-43
AB  - Neuroendocrine tumors (NETs) are relatively rare neoplasms that often present as 
      diagnostic dilemmas due to obscure or non-specific symptoms. The ability of 
      carcinoid tumors to cause clinical symptoms by secretion of hormones or biogenic 
      amines is best recognised in the form of the carcinoid syndrome. Although 
      generally slow growing, a significant minority demonstrate aggressive tumor 
      growth. Ten-twenty percent of pancreatic NETs may be associated with hereditary 
      disorders such as multiple endocrine neoplasia-1 (MEN-1) and less frequently, Von 
      Hippel Lindau, which should be considered in the investigation and management of 
      these patients. A small percentage of NETs are associated with co-existing 
      synchronous non-carcinoid neoplasm. The aim of this paper was to review the 
      optimal management in patients with NETs. The therapeutic options which are 
      reviewed, including the use of somatostatin analogues, the role of surgery, the 
      use of chemotherapy, biotherapy using interferon, peptide receptor targeted 
      therapy. In addition, the challenging interventional management of liver 
      metastases is discussed, including the role of hepatic-artery embolization, 
      radiofrequency ablation and the place of orthotoptic liver transplantation in 
      selected patients. Authors have focused on the newest therapeutic modalities, 
      e.g., radionuclide peptide receptor targeted therapy with Yttrium-90 and 
      Lutetium-177, the newest somatostatin analogues such as pasireotide and 
      angiogenic inhibitors. In conclusion, with the increasing number of investigative 
      procedures and therapeutic options available to diagnose and treat carcinoid 
      tumors, it is vital to have a multidisciplinary approach. Furthermore, additional 
      scientific research and controlled clinical trials are needed to determine the 
      efficacy of the many treatment options, which for these rare tumors can only be 
      achieved by collaboration.
FAU - Desai, K K
AU  - Desai KK
AD  - Neuroendocrine Tumor Unit, Royal Free Hospital, London, UK.
FAU - Khan, M S
AU  - Khan MS
FAU - Toumpanakis, C
AU  - Toumpanakis C
FAU - Caplin, M E
AU  - Caplin ME
LA  - eng
PT  - Journal Article
PT  - Review
PL  - Italy
TA  - Minerva Gastroenterol Dietol
JT  - Minerva gastroenterologica e dietologica
JID - 9109791
RN  - 0 (Angiogenesis Inhibitors)
RN  - 0 (Receptors, Peptide)
RN  - 51110-01-1 (Somatostatin)
RN  - 98H1T17066 (pasireotide)
SB  - IM
MH  - Angiogenesis Inhibitors/therapeutic use
MH  - Biochemistry
MH  - Carcinoid Tumor/*therapy
MH  - Embolization, Therapeutic
MH  - Gastrinoma/therapy
MH  - Hepatic Artery
MH  - Humans
MH  - Insulinoma/therapy
MH  - Liver Transplantation
MH  - Malignant Carcinoid Syndrome/therapy
MH  - Multiple Endocrine Neoplasia Type 1/complications
MH  - Neuroendocrine Tumors/complications/diagnosis/drug 
      therapy/genetics/surgery/*therapy
MH  - Pancreatic Neoplasms/complications/diagnosis/genetics/*therapy
MH  - Patient Selection
MH  - Receptors, Peptide/physiology
MH  - Somatostatin/analogs & derivatives/therapeutic use
MH  - Vipoma/therapy
MH  - von Hippel-Lindau Disease/complications
RF  - 160
EDAT- 2009/11/28 06:00
MHDA- 2010/05/04 06:00
CRDT- 2009/11/28 06:00
PHST- 2009/11/28 06:00 [entrez]
PHST- 2009/11/28 06:00 [pubmed]
PHST- 2010/05/04 06:00 [medline]
AID - R08091914 [pii]
PST - ppublish
SO  - Minerva Gastroenterol Dietol. 2009 Dec;55(4):425-43.