Neuroendocrine tumors of the small bowels are on the rise:Early aspects and management  

作　　者：Hans Scherbl Robert T Jensen Guillaume Cadiot Ulrich Stlzel Gnter Klppel 

机构地区：[1]Departments of Gastroenterology and Gastrointestinal Oncology,Vivantes Klinikum Am Urban,Berlin 10967,Germany [2]Digestive Diseases Branch,NIH,Bethesda,MD 20892,United States [3]Service d'Hépato-Gastroentérologie,Hpital Robert Debré,Reims 51092,France [4]Departments of Gastroenterology and Gastrointestinal Oncology,Klinikum Chemnitz,Chemnitz 09116,Germany [5]Institute of Pathology,Technische Universitt Mnchen,Klinikum rechts der Isar,Mnchen 81675,Germany

出　　处：《World Journal of Gastrointestinal Endoscopy》2010年第10期325-334,共10页世界胃肠内镜杂志（英文版）（电子版）

摘　　要：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 longacting 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.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.

关 键 词：CARCINOID GASTRINOMA DUODENUM JEJUNUM ILEUM Cancer Multiple endocrine NEOPLASIA 

分 类 号：R735.3[医药卫生—肿瘤]