指南与共识

欧洲神经内分泌肿瘤学会:无功能胰腺神经内分泌肿瘤2023指南解读

  • 韩亮 ,
  • 刘昊楠 ,
  • 仵正
展开
  • 西安交通大学第一附属医院肝胆外科,陕西 西安 710061
仵正,E-mail: wuzheng@126.com

收稿日期: 2024-01-12

  网络出版日期: 2024-05-14

Chinese interpretation of European Neuroendocrine Tumour Society 2023 guidance for nonfunctioning pancreatic neuroendocrine tumours

  • HAN Liang ,
  • LIU Haonan ,
  • WU Zheng
Expand
  • Department of Hepatobiliary Surgery, the First Affiliated Hospital, Xi’an Jiaotong University, Shaanxi Xi’an 710061, China

Received date: 2024-01-12

  Online published: 2024-05-14

摘要

2023年9月,Journal of Neuroendocrinology发表了欧洲神经内分泌肿瘤学会关于分化良好的无功能胰腺神经内分泌肿瘤(NF-Pan-NET)的指南。该指南由来自多学科的具有丰富诊疗经验的专家就目前临床工作中所遇到的10个棘手问题进行分析讨论并形成共识,更新其诊疗管理和临床实践建议,并强调多学科参与是NF-Pan-NET诊疗的必需环节。笔者旨在对指南重点内容进行解读,以提供规范的临床诊断与治疗流程。

本文引用格式

韩亮 , 刘昊楠 , 仵正 . 欧洲神经内分泌肿瘤学会:无功能胰腺神经内分泌肿瘤2023指南解读[J]. 外科理论与实践, 2024 , 29(01) : 14 -26 . DOI: 10.16139/j.1007-9610.2024.01.04

Abstract

This ENETS guidance for well-differentiated nonfunctioning pancreatic neuroendocrine tumours (NF-Pan-NET), which published on Journal of Neuroendocrinology (2023), has been developed by a multidisciplinary working group, and provides up-to-date and practical advice on the management of these tumours. In this guideline, the authors discussed 10 troublesome questions about clinical practice, and summarized the extensive experience of their centers treating patients with NF-Pan-NET, and suggested that multidisciplinary participation is an essential part of NF-Pan-NET diagnosis and treatment. This paper aims to interpret the key contents of the guidelines in order to provide standardized clinical diagnosis and treatment procedures in NF-Pan-NET.

参考文献

[1] KOS-KUD?A B, CASTA?O J P, DENECKE T, et al. European Neuroendocrine Tumour Society (ENETS) 2023 guidance paper for nonfunctioning pancreatic neuroendocrine tumours[J]. J Neuroendocrinol, 2023, 35(12):e13343.
[2] YANG Z, SHI G. Comparative outcomes of pancreatic neuroendocrine neoplasms: a population-based analysis of the SEER database[J]. Eur J Surg Oncol, 2022, 48(10):2181-2187.
[3] AYSAL A, AGALAR C, EGELI T, et al. Reconsideration of clinicopathologic prognostic factors in pancreatic neuroendocrine tumors for better determination of adverse prognosis[J]. Endocr Pathol, 2021, 32(4):461-472.
[4] NAGTEGAAL I D, ODZE R D, KLIMSTRA D, et al. The 2019 WHO classification of tumours of the digestive system[J]. Histopathology, 2020, 76(2):182-188.
[5] BELLIZZI A M. Immunohistochemistry in the diagnosis and classification of neuroendocrine neoplasms: what can brown do for you?[J]. Hum Pathol, 2020,96:8-33.
[6] PUSCEDDU S, PRINZI N, TAFUTO S, et al. Association of upfront peptide receptor radionuclide therapy with progression-free survival among patients with enteropancreatic neuroendocrine tumors[J]. JAMA Netw Open, 2022, 5(2):e220290.
[7] DAM G, GR?NB?K H, SORBYE H, et al. Prospective study of chromogranin A as a predictor of progression in patients with pancreatic, small-intestinal, and unknown primary neuroendocrine tumors[J]. Neuroendocrinology, 2020, 110(3-4):217-224.
[8] PAVEL M, ?BERG K, FALCONI M, et al. Gastroenteropancreatic neuroendocrine neoplasms: ESMO clinical practice guidelines for diagnosis, treatment and follow-up[J]. Ann Oncol, 2020, 31(7):844-860.
[9] MALCZEWSKA A, KOS-KUD?A B, KIDD M, et al. The clinical applications of a multigene liquid biopsy (NETest) in neuroendocrine tumors[J]. Adv Med Sci, 2020, 65(1):18-29.
[10] MALCZEWSKA A, WITKOWSKA M, WóJCIK-GIERTUGA M, et al. Prospective evaluation of the NETest as a liquid biopsy for gastroenteropancreatic and bronchopulmonary neuroendocrine tumors: an ENETS center of excellence experience[J]. Neuroendocrinology, 2021, 111(4):304-319.
[11] ?BERG K, CALIFANO A, STROSBERG J R, et al. A meta-analysis of the accuracy of a neuroendocrine tumor mRNA genomic biomarker (NETest) in blood[J]. Ann Oncol, 2020, 31(2):202-212.
[12] MODLIN I M, KIDD M, FALCONI M, et al. A multi-genomic liquid biopsy biomarker for neuroendocrine tumor disease outperforms CgA and has surgical and clinical utility[J]. Ann Oncol, 2021, 32(11):1425-1433.
[13] KOS-KUD?A B, FOLTYN W, MALCZEWSKA A, et al. Update of the diagnostic and therapeutic guidelines for gastro-entero-pancreatic neuroendocrine neoplasms (recommended by the Polish Network of Neuroendocrine Tumours) [Aktualizacja zaleceń ogólnych dotycz?cych post?powania diagnostyczno-terapeutycznego w nowotworach neuroendokrynnych uk?adu pokarmowego (rekomendowane przez Polsk? Sie? Guzów Neuroendokrynnych)][J]. Endokrynol Pol, 2022, 73(3):387-454.
[14] BLáZQUEZ-ENCINAS R, MORENO-MONTILLA M T, GARCíA-VIOQUE V, et al. The uprise of RNA biology in neuroendocrine neoplasms: altered splicing and RNA species unveil translational opportunities[J]. Rev Endocr Metab Disord, 2023, 24(2):267-282.
[15] KOS-KUD?A B, ROSIEK V, BOROWSKA M, et al. Pancreatic neuroendocrine neoplasms - update of the diagnostic and therapeutic guidelines (recommended by the Polish Network of Neuroendocrine Tumours) [Nowotwory neuroendokrynne trzustki - uaktualnione zasady diagnostyki i leczenia (rekomendowane przez Polsk? Sie? Guzów Neuroendokrynych)][J]. Endokrynol Pol, 2022, 73(3):491-548.
[16] CARLSEN E A, JOHNBECK C B, LOFT M, et al. Semiautomatic tumor delineation for evaluation of 64Cu-DOTATATE PET/CT in patients with neuroendocrine neoplasms: prognostication based on lowest lesion uptake and total tumor volume[J]. J Nucl Med, 2021, 62(11):1564-1570.
[17] BINDERUP T, KNIGGE U, JOHNBECK C B, et al. 18F-FDG PET is superior to WHO grading as a prognostic tool in neuroendocrine neoplasms and useful in guiding PRRT: a prospective 10-Year follow-up study[J]. J Nucl Med, 2021, 62(6):808-815.
[18] RICCI C, PARTELLI S, LANDONI L, et al. Sporadic non-functioning pancreatic neuroendocrine tumours: multicentre analysis[J]. Br J Surg, 2021, 108(7):811-816.
[19] HEIDSMA C M, ENGELSMAN A F, VAN DIEREN S, et al. Watchful waiting for small non-functional pancreatic neuroendocrine tumours: nationwide prospective cohort study (PANDORA)[J]. Br J Surg, 2021, 108(8):888-891.
[20] PARTELLI S, MASSIRONI S, ZERBI A, et al. Management of asymptomatic sporadic non-functioning pancreatic neuroendocrine neoplasms no larger than 2?cm: interim analysis of prospective ASPEN trial[J]. Br J Surg, 2022, 109(12):1186-1190.
[21] BOLM L, PISUCHPEN N, QADAN M, et al. Prediction of R status in resections for pancreatic cancer using simplified radiological criteria[J]. Ann Surg, 2022, 276(2):215-221.
[22] PARTELLI S, MUFFATTI F, ANDREASI V, et al. A single-center prospective observational study investiga-ting the accuracy of preoperative diagnostic procedures in the assessment of lymph node metastases in nonfunctioning pancreatic neuroendocrine tumors[J]. Ann Surg, 2022, 276(5):921-928.
[23] PARTELLI S, ANDREASI V, RANCOITA P M V, et al. Outcomes after distal pancreatectomy for neuroendocrine neoplasms: a retrospective comparison between minimally invasive and open approach using propensity score weighting[J]. Surg Endosc, 2021, 35(1):165-173.
[24] DONG D H, ZHANG X F, LOPEZ-AGUIAR A G, et al. Tumor burden score predicts tumor recurrence of non-functional pancreatic neuroendocrine tumors after curative resection[J]. HPB (Oxford), 2020, 22(8):1149-1157.
[25] ZHOU B, XIANG J, JIN M, et al. High vimentin expression with E-cadherin expression loss predicts a poor prognosis after resection of grade 1 and 2 pancreatic neuroendocrine tumors[J]. BMC Cancer, 2021, 21(1):334.
[26] HEIDSMA C M, VAN ROESSEL S, VAN DIEREN S, et al. International validation of a nomogram to predict recurrence after resection of grade 1 and 2 nonfunctioning pancreatic neuroendocrine tumors[J]. Neuroendocrino-logy, 2022, 112(6):571-579.
[27] FUSAI G K, TAMBURRINO D, PARTELLI S, et al. Portal vein resection during pancreaticoduodenectomy for pancreatic neuroendocrine tumors. An international multicenter comparative study[J]. Surgery, 2021, 169(5):1093-1101.
[28] PARTELLI S, BERTANI E, BARTOLOMEI M, et al. Peptide receptor radionuclide therapy as neoadjuvant therapy for resectable or potentially resectable pancreatic neuroendocrine neoplasms[J]. Surgery, 2018, 163(4):761-767.
[29] PARGHANE R V, BHANDARE M, CHAUDHARI V, et al. Surgical feasibility, determinants, and overall efficacy of neoadjuvant 177Lu-DOTATATE PRRT for locally advanced unresectable gastroenteropancreatic neuroendocrine tumors[J]. J Nucl Med, 2021, 62(11):1558-1563.
[30] BAUDIN EWT, BERON A, SMITH D, et al. 887O first multicentric randomized phase Ⅱ trial investigating the antitumor efficacy of peptide receptor radionucleide therapy with 177Lutetium-Octreotate (OCLU) in unresectable progressive neuroendocrine pancreatic tumor: results of the OCLURANDOM trial[J]. Ann Oncol, 2022, 33:S410-S416.
[31] CLEMENT D, NAVALKISSOOR S, SRIRAJASKANTHAN R, et al. Efficacy and safety of 177Lu?DOTATATE in patients with advanced pancreatic neuroendocrine tumours: data from the NETTER-R international, retrospective study[J]. Eur J Nucl Med Mol Imaging, 2022, 49(10):3529-3537.
[32] STARR J S, SONBOL M B, HOBDAY T J, et al. Peptide receptor radionuclide therapy for the treatment of pancreatic neuroendocrine tumors: recent insights[J]. Onco Targets Ther, 2020,13:3545-3555.
[33] ZHANG J, KULKARNI H R, SINGH A, et al. Peptide receptor radionuclide therapy in grade 3 neuroendocrine neoplasms: safety and survival analysis in 69 patients[J]. J J Nucl Med, 2019, 60(3):377-385.
[34] CARLSEN E A, FAZIO N, GRANBERG D, et al. Peptide receptor radionuclide therapy in gastroenteropancreatic NEN G3: a multicenter cohort study[J]. Endocr Relat Cancer, 2019, 26(2):227-239.
[35] THANG S P, LUNG M S, KONG G, et al. Peptide receptor radionuclide therapy (PRRT) in European Neuroendocrine Tumour Society (ENETS) grade 3 (G3) neuroendocrine neoplasia (NEN)-a single-institution retrospective analysis[J]. Eur J Nucl Med Mol Imaging, 2018, 45(2):262-277.
[36] ZEMCZAK A, GUT P, PAWLAK D, et al. The safety and efficacy of the repeated PRRT with [90Y]Y/[177Lu]Lu-DOTATATE in patients with NET[J]. Int J Endocrinol, 2021,2021:6615511.
[37] HARRIS P E, ZHERNOSEKOV K. The evolution of PRRT for the treatment of neuroendocrine tumors; What comes next?[J]. Front Endocrinol (Lausanne), 2022,13:941832.
[38] STROSBERG J, LEEUWENKAMP O, SIDDIQUI M K. Peptide receptor radiotherapy re-treatment in patients with progressive neuroendocrine tumors: a systematic review and meta-analysis[J]. Cancer Treat Rev, 2021,93:102141.
[39] MEROLA E, ALONSO GORDOA T, ZHANG P, et al. Somatostatin analogs for pancreatic neuroendocrine tumors: any benefit when Ki-67 is ≥10%?[J] Oncologist, 2021, 26(4):294-301.
[40] JONASCH E, DONSKOV F, ILIOPOULOS O, et al. Belzutifan for renal cell carcinoma in von hippel-lindau disease[J]. N Engl J Med, 2021, 385(22):2036-2046.
[41] KUNZ P L, GRAHAM N T, CATALANO P J, et al. Randomized study of temozolomide or temozolomide and capecitabine in patients with advanced pancreatic neuroendocrine tumors (ECOG-ACRIN E2211)[J]. J Clin Oncol, 2023, 41(7):1359-1369.
[42] CHAN D L, BERGSLAND E K, CHAN J A, et al. Temozolomide in grade 3 gastroenteropancreatic neuroendocrine neoplasms: a multicenter retrospective review[J]. Oncologist, 2021, 26(11):950-955.
[43] LAHNER H, MATHEW A, KLOCKER A L, et al. Streptozocin/5-fluorouracil chemotherapy of pancreatic neuroendocrine tumours in the era of targeted therapy[J]. Endocrine, 2022, 75(1):293-302.
[44] DE MESTIER L, WALTER T, EVRARD C, et al. Temozolomide alone or combined with capecitabine for the treatment of advanced pancreatic neuroendocrine tumor[J]. Neuroendocrinology, 2020, 110(1-2):83-91.
[45] STROSBERG J, KUNZ P L, HENDIFAR A, et al. Impact of liver tumour burden, alkaline phosphatase elevation, and target lesion size on treatment outcomes with 177Lu-Dotatate: an analysis of the NETTER-1 study[J]. Eur J Nucl Med Mol Imaging, 2020, 47(10):2372-2382.
[46] MEROLA E, PRASAD V, PASCHER A, et al. Peritoneal carcinomatosis in gastro-entero-pancreatic neuroendocrine neoplasms: clinical impact and effectiveness of the available therapeutic options[J]. Neuroendocrinology, 2020, 110(6):517-524.
[47] SALAZAR RTS, KROGH M, TEULE A, et al. Rando-mized open label phase Ⅲ study comparing the efficacy and safety of everolimus followed by chemotherapy (CT) with streptozotocin (STZ)-5FU upon progression or the reverse sequence, in advanced progressive panNETs: the SEQ-TOR study (GETNE 1206)[J]. Ann Oncol, 2022, 33(suppl 7):S808-S869.
[48] VAN DEN BROEK M F M, VAN NESSELROOIJ B P M, PIETERMAN C R C, et al. Clues for genetic anticipation in multiple endocrine neoplasia type 1[J]. J Clin Endocrinol Metab, 2020, 105(7):dgaa257.
[49] CUTHBERTSON D J, BARRIUSO J, LAMARCA A, et al. The impact of 68Gallium DOTA PET/CT in mana-ging patients with sporadic and familial pancreatic neuroendocrine tumours[J]. Front Endocrinol (Lausanne), 2021,12:654975.
[50] PIETERMAN C R C, VALK G D. Update on the clinical management of multiple endocrine neoplasia type 1[J]. Clin Endocrinol (Oxf), 2022, 97(4):409-423.
[51] SADOWSKI S M, PIETERMAN C R C, PERRIER N D, et al. Prognostic factors for the outcome of nonfunctioning pancreatic neuroendocrine tumors in MEN1: a systematic review of literature[J]. Endocr Relat Cancer, 2020, 27(6):R145-R161.
[52] PULVIRENTI A, JAVED A A, LANDONI L, et al. Multi-institutional development and external validation of a nomogram to predict recurrence after curative resection of pancreatic neuroendocrine tumors[J]. Ann Surg, 2021, 274(6):1051-1057.
文章导航

/