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- Title:
Management of early gastrointestinal neuroendocrine neoplasms.
- Document type:
- Journal Article
- Author(s):
- Scherübl, H; Jensen, RT; Cadiot, G; Stölzel, U; Klöppel, G
- Abstract:
- Neuroendocrine neoplasms (NENs) of the stomach, duodenum, appendix or rectum that are small (<= 1 cm) and well differentiated can be considered "early" tumors, since they generally have a (very) good prognosis. In the new WHO classification of 2010, these neoplasms are called neuroendocrine tumors/ carcinoids (NETs), grade (G) 1 or 2, and distinguished from poorly differentiated neuroendocrine carcinomas (NECs), G3. NETs are increasing, with a rise in the age-adjusted incidence in the U.S.A. by about 700 % in the last 35 years. Improved early detection seems to be the main reason for these epidemiological changes. Both the better general availability of endoscopy, and imaging techniques, have led to a shift in the discovery of smaller-sized (<= 10-20 mm) intestinal NETs/carcinoids and earlier tumor stages at diagnosis. Endoscopic screening is therefore effective in the early diagnosis, not only of colorectal adenocarcinomas, but also of NETs/carcinoids. Endoscopic removal, followed up with endoscopic surveillance is the treatment of choice in NETs/carcinoids of the stomach, duodenum and rectum that are <= 10 mm in size, have a low proliferative activity (G1), do not infiltrate the muscular layer and show no angioinvasion. In all the other intestinal NENs, optimal treatment generally needs surgery and/or medical therapy depending on type, biology and stage of the tumor, as well as the individual situation of the patient.
- Journal title abbreviation:
- World J Gastrointest Endosc
- Year:
- 2011
- Journal volume:
- 3
- Journal issue:
- 7
- Pages contribution:
- 133-9
- Language:
- eng
- Fulltext / DOI:
- doi:10.4253/wjge.v3.i7.133
- Pubmed ID:
- http://view.ncbi.nlm.nih.gov/pubmed/21860682
- TUM Institution:
- Institut für Allgemeine Pathologie und Pathologische Anatomie
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