Review
Endocrinology & Metabolism
James Y. Lim, Rodney F. Pommier
Summary: Small bowel neuroendocrine tumors are rare, with challenges in early detection, but genetic predisposition plays a significant role in familial cases. Screening for familial small bowel neuroendocrine tumors can lead to earlier diagnosis and improved patient outcomes.
FRONTIERS IN ENDOCRINOLOGY
(2021)
Article
Surgery
Julie Hallet, Calvin Law
Summary: The debate over resection of the primary tumor in stage IV small bowel neuroendocrine tumors (SB-NETs) continues, with reported survival benefits conflicting due to selection bias. The main clinical benefits of primary tumor resection include prevention of debilitating complications. Assessment and surgical management by experienced surgeons is recommended to consider resection of the primary tumor despite metastatic disease.
WORLD JOURNAL OF SURGERY
(2021)
Article
Surgery
Julie Hallet, Calvin Law
Summary: The management of nodal disease in SB-NETs remains controversial, with debates on the extent of lymph node dissection for localized tumors. While resection is important, it should be balanced with functional outcomes. Nodal dissection is useful for staging in localized disease, but the benefit in survival remains unclear. Different stages of nodal extent should be considered in loco-regional disease to guide appropriate resection strategies.
WORLD JOURNAL OF SURGERY
(2021)
Review
Oncology
Catherine G. Tran, Scott K. Sherman, James R. Howe
Summary: Surgical resection is crucial for treating small bowel neuroendocrine tumors, improving symptoms, preventing complications, and extending survival. Medical treatments such as somatostatin analogues, targeted therapy, and peptide receptor radionuclide therapy have shown benefits in improving progression-free survival in advanced NETs.
ANNALS OF SURGICAL ONCOLOGY
(2021)
Article
Oncology
Catherine G. Tran, Scott K. Sherman, Aaron T. Scott, Po Hien Ear, Chandrikha Chandrasekharan, Andrew M. Bellizzi, Joseph S. Dillon, Thomas M. O'Dorisio, James R. Howe
Summary: This study found that elevated levels of CgA, PST, and NKA during follow-up after surgery for SBNETs were associated with lower progression-free survival and overall survival, with PST demonstrating better discrimination of outcomes. Using PST most accurately detected disease progression during the follow-up period.
ANNALS OF SURGICAL ONCOLOGY
(2021)
Article
Oncology
J. Yu, E. Refsum, V Perrin, L. M. Helsingen, P. Wieszczy, M. Loberg, M. Bretthauer, H. O. Adami, W. Ye, J. Blom, M. Kalager
Summary: This population-based cohort study found that patients with inflammatory bowel disease (IBD) have a higher risk of small bowel adenocarcinoma and neuroendocrine tumors. Specifically, patients with Crohn's disease (CD) had an eightfold increased risk of small bowel adenocarcinoma, patients with both UC and CD had about a twofold increased risk of neuroendocrine tumors, and patients with UC had a twofold increased risk of small bowel adenocarcinoma. However, due to the small absolute excess cancer risk, active surveillance to diagnose small intestinal cancer early may not be cost-effective.
ANNALS OF ONCOLOGY
(2022)
Article
Surgery
Janice L. Pasieka
Summary: In contemporary surgical series, the incidence of multifocal tumours (MFT) in small bowel neuroendocrine tumours (SBNET) is high, posing challenges and questions for operating surgeons. The etiology of these multiple tumours may be multifactorial, involving local metastases, genetic mutations, or genetic and epigenetic events within the bowel. Contrary to historical series, recent data suggest that MFT are not associated with a poorer prognosis, highlighting the need for long-term surveillance of these unique tumours.
WORLD JOURNAL OF SURGERY
(2021)
Article
Oncology
Timothy P. Diperi, Nicholas Manguso, Jun Gong, Katelyn M. Atkins, Andrew E. Hendifar, Alexandra Gangi
Summary: This study investigated the impact of demographic and socioeconomic factors on overall survival for patients with small bowel neuroendocrine tumors. It found that lower income, lower education, not living in proximity to a metro area, and treatment at a community cancer center were associated with worse 5-year survival. Strategies to improve access to care should be considered for this at-risk population.
JOURNAL OF SURGICAL ONCOLOGY
(2023)
Article
Oncology
Niko Hiltunen, Jukka Rintala, Juha P. Vayrynen, Jan Bohm, Tuomo J. Karttunen, Heikki Huhta, Olli Helminen
Summary: This study found that high MCT4 expression is associated with improved prognosis in small bowel neuroendocrine tumors (SB-NETs), while MCT1 expression is not correlated with survival.
Article
Surgery
Sarah M. Wonn, Kristen E. Limbach, SuEllen J. Pommier, Anna N. Ratzlaff, E. J. Leon, Belinda H. McCully, Rodney F. Pommier
Summary: The study demonstrates that a majority of patients with small bowel neuroendocrine tumors with peritoneal carcinomatosis and liver metastases can benefit from cytoreduction. Complete clearance of tumors leads to the best survival times, but there is also improved survival for patients with Lyon Stage <= 1. In patients with liver metastases, the best survival outcomes after cytoreduction are seen when both Lyon Stage <= 1 and >70% liver metastases are achieved.
Article
Surgery
Sean Bennett, Natalie Coburn, Calvin Law, Alyson Mahar, Haoyu Zhao, Simron Singh, Victoria Zuk, Sten Myrehaug, Vaibhav Gupta, Jordan Levy, Julie Hallet
Summary: In this study, the impact of upfront small bowel resection (USBR) for metastatic small bowel neuroendocrine (SB-NET) compared to nonoperative management (NOM) on long-term healthcare utilization and survival outcomes was examined. The results showed that USBR was associated with decreased subsequent admissions and small bowel-related surgeries compared to NOM for patients with metastatic SB-NET.
Article
Medicine, General & Internal
Toshitaka Sugawara, Salvador Rodriguez Franco, Michael J. Kirsch, Kathryn L. Colborn, Jun Ishida, Samuele Grandi, Mohammed H. Al-Musawi, Ana Gleisner, Marco Del Chiaro, Richard D. Schulick
Summary: The study aimed to evaluate the association between surgical resection for small NF-PanNETs measuring 2 cm or smaller and survival. Data from the National Cancer Database were used, and patients diagnosed with NF-pancreatic neuroendocrine neoplasms between January 1, 2004, and December 31, 2017 were included. Surgical resection was associated with longer survival in select patients with NF-PanNETs measuring 1.1 to 2.0 cm who were younger than 65 years, had no comorbidities, received treatment at academic institutions, and had tumors of the distal pancreas.
Review
Endocrinology & Metabolism
Federica Grillo, Manuela Albertelli, Pasqualino Malandrino, Andrea Dotto, Genoveffa Pizza, Giuseppe Cittadini, Annamaria Colao, Antongiulio Faggiano
Summary: Well-differentiated, low-grade neuroendocrine tumors (NETs) in the small bowel have a tendency to metastasize despite their slow growth. Extended regional mesenteric lymphadenectomy and the presence of mesenteric tumor deposits (MTDs) may be prognostic indicators for small bowel NETs.
JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM
(2022)
Article
Oncology
Taymeyah Al-Toubah, Brian Morse, Jonathan Strosberg
Summary: The CAPTEM regimen shows significant activity in high-grade small bowel NETs, but is less effective in patients with low/intermediate-grade tumors.
Article
Oncology
Akie Watanabe, Geoffrey Mckendry, Lily Yip, Jonathan M. Loree, Heather C. Stuart
Summary: This study evaluated the impact of surveillance imaging on recurrence and overall survival in patients with resected small bowel neuroendocrine tumors (SB-NETs). The results showed that imaging frequency was predictive of recurrence, and patients who received treatment for recurrent disease had comparable overall survival to those who did not recur. Additionally, less frequent imaging over a longer duration was emphasized to capture clinically relevant recurrences that can be treated to improve overall survival.
JOURNAL OF SURGICAL ONCOLOGY
(2023)
Article
Surgery
Sarah Kelley, Anna C. Beck, Ronald J. Weigel, James R. Howe, Sonia L. Sugg, Geeta Lal
Summary: This study assessed the impact of an institutional Endocrine MDT, finding that MDT presentations led to a higher rate of management changes, especially for recurrent TC patients, and increased evidenced-based practice among attendees. Attendees reported that the conference exceeded educational expectations, with a growing trend towards using evidence and guideline-based approaches.
AMERICAN JOURNAL OF SURGERY
(2022)
Article
Oncology
Catherine G. Tran, Scott K. Sherman, Mohammed O. Suraju, Apoorve Nayyar, Henning Gerke, Rami G. El Abiad, Chandrikha Chandrasekharan, Po Hien Ear, Thomas M. O'Dorisio, Joseph S. Dillon, Andrew M. Bellizzi, James R. Howe
Summary: The management of duodenal neuroendocrine tumors (DNETs) varies depending on the size of the lesion, with smaller ones typically treated by endoscopic mucosal resection (EMR) and larger ones by surgical resection (SR). A study comparing outcomes between patients who underwent EMR and SR showed that there was no significant difference in survival rates, particularly in 1-2 cm DNETs. However, surgically resected DNETs had improved progression-free survival (PFS) and overall survival (OS) compared to jejunoileal NETs.
ANNALS OF SURGICAL ONCOLOGY
(2022)
Article
Endocrinology & Metabolism
Rodney J. Hicks, Clarisse Dromain, Wouter W. de Herder, Frederico P. Costa, Christophe M. Deroose, Andrea Frilling, Anna Koumarianou, Eric P. Krenning, Eric Raymond, Lisa Bodei, Halfdan Sorbye, Staffan Welin, Bertram Wiedenmann, Damian Wild, James R. Howe, James Yao, Dermot O'Toole, Anders Sundin, Vikas Prasad
Summary: ENETS aims to improve the standard of care for patients with neuroendocrine neoplasms (NEN) by providing standardized reporting guidance for diagnostic studies, including pathology, radiology, endoscopy, and molecular imaging. A reporting template for personalized therapies in molecular imaging procedures has been developed and is undergoing pilot implementation within the ENETS Center of Excellence network, with plans for harmonization with other specialist imaging societies.
JOURNAL OF NEUROENDOCRINOLOGY
(2022)
Article
Surgery
Anna C. Beck, Anand Rajan, Shannon Landers, Sarah Kelley, Andrew M. Bellizzi, Geeta Lal, Sonia L. Sugg, James R. Howe, Carlos H. Chan, Ronald J. Weigel
Summary: The study showed that the tall cell variant of papillary thyroid carcinoma has increased expression of cancer stem cell markers compared to classic papillary thyroid carcinoma. A gene signature similar to the tall cell variant identified a subtype of classic papillary thyroid carcinoma with worse recurrence-free survival.
Editorial Material
Oncology
Catherine G. Tran, Scott K. Sherman, James R. Howe
Summary: The optimal management of duodenal neuroendocrine tumors (DNETs) has not been well-defined, especially for DNETs 1-2 cm in size. Recent studies have shown that endoscopic mucosal resection (EMR) is a safe and effective option for these intermediate-sized DNETs, which may lead to updates in expert and consensus guidelines.
ANNALS OF SURGICAL ONCOLOGY
(2022)
Review
Medicine, Research & Experimental
Amy Chang, Scott K. Sherman, James R. Howe, Vaibhav Sahai
Summary: Pancreatic neuroendocrine tumors (PNETs) are a heterogeneous group of neoplasms with varying treatment options. The treatment approach depends on factors such as tumor stage, grade and differentiation, symptoms, tumor burden, and rate of progression. Recent advancements in treatment have positively impacted patient care and prognosis.
ANNUAL REVIEW OF MEDICINE
(2022)
Review
Gastroenterology & Hepatology
James R. Howe
Summary: Advances in understanding the genetic basis of colorectal cancer have led to pre-symptomatic detection and targeted therapy, with the introduction of circulating tumor DNA into patient management showing promise in changing treatment paradigms.
ANNALS OF GASTROENTEROLOGICAL SURGERY
(2022)
Article
Gastroenterology & Hepatology
Suzanne P. MacFarland, Hongbo Xie, Maiah H. Dent, Bridgid Greed, Sharon E. Plon, Sarah R. Scollon, Garrett M. Brodeur, James R. Howe
Summary: Juvenile polyposis syndrome (JPS) is a childhood polyposis syndrome with a high risk of gastrointestinal cancer. Inactivation of the FOCAD gene may be the genetic cause of JPS.
JOURNAL OF PEDIATRIC GASTROENTEROLOGY AND NUTRITION
(2022)
Article
Oncology
Catherine G. Tran, Luis C. Borbon, Jacqueline L. Mudd, Ellen Abusada, Solmaz AghaAmiri, Sukhen C. Ghosh, Servando Hernandez Vargas, Guiying Li, Gabriella Beyer, Mary McDonough, Rachel Li, Carlos H. F. Chan, Susan A. Walsh, Thaddeus J. Wadas, Thomas O'Dorisio, M. Sue O'Dorisio, Ramaswamy Govindan, Paul F. Cliften, Ali Azhdarinia, Andrew M. Bellizzi, Ryan C. Fields, James R. Howe, Po Hien Ear
Summary: Gastroenteropancreatic neuroendocrine neoplasms (GEP NENs) are rare cancers with increasing incidence. The lack of suitable cellular and animal models for studying and testing new therapies has posed challenges for research on GEP NENs. This study successfully established two PDX models (NEC913 and NEC1452) and demonstrated their utility in drug discovery and research on GEP NENs.
Article
Oncology
Luis C. Borbon, Catherine G. Tran, Scott K. Sherman, Po Hien Ear, Chandrikha Chandrasekharan, Andrew M. Bellizzi, Joseph S. Dillon, Thomas M. O'Dorisio, James R. Howe
Summary: This study evaluated outcomes of surgically treated Grade 3 gastroenteropancreatic neuroendocrine neoplasm (G3 GEP-NEN) patients, finding a significantly lower overall survival rate in resected G3 NEN patients compared to those with Grade 1/2 tumors. Surgical resection of G3 GEP-NENs remains controversial, but for carefully selected patients, especially those with well-differentiated tumors, surgery may be a consideration.
ANNALS OF SURGICAL ONCOLOGY
(2022)
Editorial Material
Oncology
James R. Howe
ANNALS OF SURGICAL ONCOLOGY
(2022)
Review
Oncology
Ioannis A. Ziogas, Panagiotis T. Tasoudis, Luis C. Borbon, Scott K. Sherman, Patrick J. Breheny, Chandrikha Chandrasekharan, Joseph S. Dillon, Andrew M. Bellizzi, James R. Howe
Summary: Surgical management may offer a potential survival benefit for G3 gastroenteropancreatic neuroendocrine neoplasms (GEP NENs), but further research is needed to determine which patients will benefit most from surgery.
ANNALS OF SURGICAL ONCOLOGY
(2023)
Editorial Material
Oncology
Ioannis A. Ziogas, Joseph S. Dillon, Chandrikha Chandrasekharan, James R. Howe
ANNALS OF SURGICAL ONCOLOGY
(2023)
Editorial Material
Oncology
Ioannis A. Ziogas, Panagiotis T. Tasoudis, Luis C. Borbon, Scott K. Sherman, Patrick J. Breheny, Chandrikha Chandrasekharan, Joseph S. Dillon, Andrew M. Bellizzi, James R. Howe
ANNALS OF SURGICAL ONCOLOGY
(2023)
Article
Surgery
Mohammed O. Suraju, Anthony Snow, Apoorve Nayyar, Jeremy Chang, Scott K. Sherman, Hisakazu Hoshi, James R. Howe, Carlos H. F. Chan
Summary: This study reviewed the prevalence, risk factors, and prognosis of peritoneal metastases (PMs) following resection of pancreatic intraductal papillary mucinous neoplasms (IPMNs) using the institution's experience and published literature. The study found that PMs are rare but may be more common in patients with invasive histology. Noninvasive IPMNs can also give rise to PMs. Further research is needed to understand the pathophysiology and risk factors of PM following IPMN resection and reinforce adherence to guidelines recommending long-term surveillance.
JOURNAL OF SURGICAL RESEARCH
(2023)
