TNM staging of foregut (neuro)endocrine tumors: A consensus proposal including a grading system

G. Rindi, G. Klöppel, H. Alhman, M. Caplin, A. Couvelard, W. W. De Herder, B. Erikssson, A. Falchetti, M. Falconi, P. Komminoth, M. Körner, J. M. Lopes, A. M. McNicol, O. Nilsson, A. Perren, A. Scarpa, J. Y. Scoazec, B. Wiedenmann, R. Arnold, W. O. BechsteinG. Cadiot, E. Christ, D. Chung, G. Delle Fave, D. Ferone, P. Goretzki, D. Gross, D. Hochhauser, R. Hyrdel, R. Jensen, G. Kaltsas, F. Keletimur, R. Kianmanesh, W. Knapp, U. P. Knigge, B. Kos-Kuda, L. Kvols, D. Kwekkeboom, V. Lewington, R. Manfredi, E. Mitry, B. Niederle, G. Nikou, K. Öberg, J. O'Connor, D. O'Toole, S. Pauwels, M. Pavel, U. Plöckinger, J. Ramage, J. Ricke, P. Ruszniewski, R. Salazar, A. Sauvanet, M. I. Sevilla Garcia, T. A. Steinmüller, A. Sundin, B. Taal, E. Van Cutsem, M. P. Vullierme, S. Wildi, J. C. Yao

Research output: Contribution to journalArticlepeer-review


The need for standards in the management of patients with endocrine tumors of the digestive system prompted the European Neuroendocrine Tumor Society (ENETS) to organize a first Consensus Conference, which was held in Frascati (Rome) and was based on the recently published ENETS guidelines on the diagnosis and treatment of digestive neuroendocrine tumors (NET). Here, we report the tumor-node-metastasis proposal for foregut NETs of the stomach, duodenum, and pancreas that was designed, discussed, and consensually approved at this conference. In addition, we report the proposal for a working formulation for the grading of digestive NETs based on mitotic count and Ki-67 index. This proposal, which needs to be validated, is meant to help clinicians in the stratification, treatment, and follow-up of patients.

Original languageEnglish
Pages (from-to)395-401
Number of pages7
JournalVirchows Archiv
Issue number4
Publication statusPublished - Oct 2006


  • Grading
  • Gut
  • Ki-67 index
  • Mitotic index
  • Neuroendocrine tumors
  • Pancreas
  • Staging
  • TNM

ASJC Scopus subject areas

  • Pathology and Forensic Medicine


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