Abstract
The incidence gastroenteropancreatic neuroendocrine neoplasms (GEP-NENs) has dramatically
risen over the last three decades, probably due to the increased detection of asymptomatic
lesions. The diagnostic work-up for patients with suspected GEP-NENs is based on conventional
imaging, endoscopy, pathology, and functional imaging, including 68Gallium-DOTATATE PET and 18F-FDG PET. The choice of the best treatment strategy should be based on the evaluation
of tumor-related features and patient's characteristics. A conservative management,
consisting of active surveillance or endoscopic resection, has been advocated for
patients with small, incidentally discovered, nonfunctioning tumors without features
of aggressiveness. On the other hand, surgery with lymphadenectomy, also with a minimally
invasive approach, represents the gold standard for the curative treatment of localized
disease. Moreover, surgical resection plays an important role also in the context
of a multimodal treatment strategy for patients with advanced GEP-NENs. Finally, a
wide range of medical therapies, comprising somatostatin analogues, peptide receptor
radionuclide therapy, target therapies and several chemotherapy regimens, can be offered
to patients with advanced GEP-NENs not amenable of surgical resection, according to
the biological and molecular features of their disease.
Keywords
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Article info
Publication history
Published online: September 07, 2020
Accepted:
August 21,
2020
Received:
June 11,
2020
Identification
Copyright
© 2020 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.
