Journal of the National Cancer Institute Advance Access published online on September 9, 2008
JNCI Journal of the National Cancer Institute, doi:10.1093/jnci/djn275
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© The Author 2008. Published by Oxford University Press.
COMMENTARY |
Priorities for Improving the Management of Gastroenteropancreatic Neuroendocrine Tumors
Affiliations of authors: Department of Gastroenterological Surgery, Yale University, New Haven, CT (IMM); Department of Medicine, Rhode Island Hospital/Brown University, Providence, RI (SFM); Gastrointestinal Unit, Department of Medicine, Massachusetts General Hospital/Harvard University, Boston, MA (DCC); Digestive Diseases Branch, National Institute of Diabetes and Digestive and Kidney Diseases (RTJ) and National Cancer Institute (ES), National Institutes of Health, Bethesda, MD
Correspondence to: Irvin M. Modlin, MD, PhD, DSc, FRCS, Department of Gastroenterological Surgery, Yale University School of Medicine, PO Box 208062, New Haven, CT 06520-8062 (e-mail: imodlin{at}optonline.net).
A National Cancer Institute summit meeting on gastroenteropancreatic neuroendocrine and carcinoid tumors was held in September 2007 to present the currently accepted standards of care for patients with these tumors and to identify areas requiring investigation and development. These tumors are clinically and pathologically heterogeneous, present commonly with obscure symptoms that lead to delays in diagnosis of years, and have an incidence in the United States of 2.5 to 5 cases per 100 000. The 5-year survival rates range between 15% and 95%, depending on the site and extent of disease. This report delineates the main conclusions of the meeting, including the best practice diagnosis and treatment strategies for gastropancreatic neuroendocrine tumors, and the identification of clinical and scientific areas that are most in need of attention. The most pressing needs were public and physician education, identification of molecular markers for early diagnosis and therapeutic monitoring, improved imaging modalities and molecular prognostication, development of a standardized pathological classification system, and creation of regional centers of expertise with tumor and laboratory data banks. In addition, adequately validated neuroendocrine tumor models and cell lines should be established to investigate the molecular mechanisms involved in the control of their growth and secretion, and to facilitate the development of specific therapies that should be examined in well-designed multicenter studies of defined patient groups.
Manuscript received February 11, 2008; revised June 23, 2008; accepted July 8, 2008.
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