Neuroendocrine tumors are a heterogeneous group of neoplasms that have in common the expression of specific molecules, proteins and receptors that constitute the neuroendocrine phenotype. This biological peculiarity is extremely useful for the diagnosis and the follow up and different molecular pathways can be used as focused therapeutic targets. Although these tumors are characterized by a high neuroendocrine secretory activity, only a minority of them arises with a specific hyper-secretory endocrine syndrome. Usually, the diagnosis is made fortuitously during a radiological exam or during a surgical operation. For this reason, histological and immunohistochemical characterization is extremely important and it must follow the international criteria of the last WHO classification of neuroendocrine tumors. Once the diagnosis of neuroendocrine tumor has been confirmed it is necessary to make an accurate evaluation of biological markers, that are useful for the identification of the primary tumor and for the follow up. Radiological evaluation includes conventional radiological techniques such as ultrasonography, computed tomography and magnetic resonance imaging, endoscopic and echo-endoscopic procedures and nuclear-medicine techniques like octreoscan. All of these should be performed in a multidisciplinary context and in specialized centres. The same should be done for therapeutic procedures, that should consider all of the therapeutic possibilities that are today available for neuroendocrine tumors including conventional anti-cancer therapies such as surgery and non conventional therapies, such as biotherapy (somatostatin analogues and Interferon), radio-receptorial therapies and locoregional therapies. Chemotherapy should be restricted to the most aggressive tumors. Nowadays new compounds are available or under evaluation in clinical trials. The therapeutic strategy should be modulated considering clinical and biological aggressiveness of the tumor and should be based not only on tumor responsiveness to treatment, but alsoon survival and the quality of life of the patients.
|Translated title of the contribution||Diagnostic-therapeutic algorithm of neuroendocrine tumors|
|Number of pages||5|
|Publication status||Published - Jun 2007|
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