Scherübl H, Jensen RT, Cadiot G, Stölzel U, Klöppel G. Neuroendocrine tumors of the small bowels are on the rise: Early aspects and management. World J Gastrointest Endosc 2010; 2(10): 325-334 [PMID: 21160582 DOI: 10.4253/wjge.v2.i10.325]
Corresponding Author of This Article
Hans Scherübl, MD, Professor, Klinik für Innere Medizin - Gastroenterologie und Gastrointestinale Onkologie, Vivantes-Klinikum Am Urban Dieffenbachstrasse 1, Berlin 10967, Germany. hans.scheruebl@vivantes.de
Article-Type of This Article
Editorial
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Endosc. Oct 16, 2010; 2(10): 325-334 Published online Oct 16, 2010. doi: 10.4253/wjge.v2.i10.325
Neuroendocrine tumors of the small bowels are on the rise: Early aspects and management
Hans Scherübl, Robert T Jensen, Guillaume Cadiot, Ulrich Stölzel, Günter Klöppel
Hans Scherübl, Departments of Gastroenterology and Gastrointestinal Oncology, Vivantes Klinikum Am Urban, Berlin 10967, Germany
Robert T Jensen, Digestive Diseases Branch, NIH, Bethesda, MD 20892, United States
Guillaume Cadiot, Service d’Hépato-Gastroentérologie, Hôpital Robert Debré, Reims 51092, France
Ulrich Stölzel, Departments of Gastroenterology and Gastrointestinal Oncology, Klinikum Chemnitz, Chemnitz 09116, Germany
Günter Klöppel, Institute of Pathology, Technische Universität München, Klinikum rechts der Isar, München 81675, Germany
Author contributions: Scherübl H acquired the data, conceived and wrote the manuscript; Jensen RT, Cadiot G and Stölzel U clinically interpreted and wrote the manuscript; and Klöppel G performed clinical interpretation, conceived and wrote the manuscript.
Correspondence to: Hans Scherübl, MD, Professor, Klinik für Innere Medizin - Gastroenterologie und Gastrointestinale Onkologie, Vivantes-Klinikum Am Urban Dieffenbachstrasse 1, Berlin 10967, Germany. hans.scheruebl@vivantes.de
Telephone: +49-30-130225201 Fax: +49-30-130225205
Received: May 10, 2010 Revised: August 2, 2010 Accepted: August 9, 2010 Published online: October 16, 2010
Abstract
Neuroendocrine tumors of the small bowel are on the rise. In the US they have increased by 300%-500% in the last 35 years. At the same time their prognosis is much improved. Today, most neuroendocrine tumors (NETs) of the duodenum are detected “incidentally” and therefore recognized at an early stage. Duodenal NETs which are well differentiated, not larger than 10 mm and limited to the mucosa/submucosa can be endoscopically resected. The management of duodenal NETs ranging between 10 and 20 mm needs an interdisciplinary discussion. Endoscopic ultrasound is the method of choice to determine tumor size and depth of infiltration. Surgery is recommended for well-differentiated duodenal NET tumors greater than 20 mm, for localized sporadic gastrinomas (of any size) and for localized poorly differentiated NE cancers. Surgery is recommended for any ileal NET. Advanced ileal NETs with a carcinoid syndrome are treated with long-acting somatostatin analogs. This treatment significantly improves (progression-free) survival in patients with metastatic NETs of the ileum. For optimal NET management, tumor biology, type, localization and stage of the neoplasm, as well as the patient’s individual circumstances have to be taken into account.
