Gastroenteropancreatic high-grade neuroendocrine carcinoma Journal Article
| Authors: | Sorbye, H.; Strosberg, J.; Baudin, E.; Klimstra, D. S.; Yao, J. C. |
| Article Title: | Gastroenteropancreatic high-grade neuroendocrine carcinoma |
| Abstract: | Gastroenteropancreatic (GEP) neuroendocrine neoplasms are classified as low-grade, intermediate-grade, and high-grade tumors based on morphologic criteria and the proliferation rate. Most studies have been conducted in patients with well differentiated (low-grade to intermediate-grade) neuroendocrine tumors. Data are substantially scarcer on poorly differentiated, high-grade neuroendocrine carcinoma (NEC), which includes the entities of small cell carcinoma and large cell NEC. A literature search of GEP-NEC was performed. Long-term survival was poor even among patients who presented with localized disease. Several studies highlighted heterogeneity within the high-grade NEC category and a need for the further identification of discreet prognostic and predictive groups. Tumors with a Ki-67 proliferation index <55% were less responsive to platinum-based chemotherapy, and patients with such tumors or with well differentiated morphology had better survival than patients who had tumors with poorly differentiated morphology or a higher Ki-67 index. Treatment options beyond platinum-based chemotherapy are emerging. A revision of the World Health Organization high-grade NEC classification seems to be necessary based on recent data. Platinum-based chemotherapy may not be the optimal treatment for patients who have GEP-NEC with a moderately high proliferation rate. Adequate diagnostic and prognostic stratifications constitute the basis for future progress. |
| Keywords: | cancer chemotherapy; cancer survival; cancer surgery; review; cancer localization; cisplatin; fluorouracil; cancer growth; capecitabine; paclitaxel; cancer adjuvant therapy; pancreatic neoplasms; temozolomide; cancer diagnosis; cancer incidence; cancer grading; ki 67 antigen; carboplatin; progression free survival; antineoplastic metal complex; etoposide; palliative therapy; tumor biopsy; pathology; cancer mortality; irinotecan; neuroendocrine tumor; gastrointestinal neoplasms; survival time; folinic acid; pancreas tumor; carcinoma; cancer epidemiology; large cell carcinoma; cancer classification; oxaliplatin; somatostatin derivative; neuroendocrine tumors; small cell carcinoma; carcinoma, small cell; neuroendocrine; carcinoma, large cell; gastrointestinal tumor; gastrointestinal; gastroenteropancreatic neuroendocrine tumor; endocrine; cancer prognosis; neoplasm grading; humans; prognosis; human; gastroenteropancreatic; gastroenteropancreatic neuroendocrine carcinoma |
| Journal Title: | Cancer |
| Volume: | 120 |
| Issue: | 18 |
| ISSN: | 0008-543X |
| Publisher: | Wiley Blackwell |
| Date Published: | 2014-09-15 |
| Start Page: | 2814 |
| End Page: | 2823 |
| Language: | English |
| DOI: | 10.1002/cncr.28721 |
| PUBMED: | 24771552 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | Export Date: 1 December 2014 -- Source: Scopus |
