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Multidisciplinary Management of Neuroendocrine Neoplasia: A Real-World Experience from a Referral Center

1
Digestive Disease Unit, ENETS Center of Excellence, Sant’Andrea University Hospital, 00189 Rome, Italy
2
Medical Oncology Unit, ENETS Center of Excellence, Sant’Andrea University Hospital, 00189 Rome, Italy
3
Department of Clinical and Molecular Medicine, “Sapienza” University of Rome, 00189 Rome, Italy
4
Pathologic Anatomy and Molecular Morphology Unit, ENETS Center of Excellence, Sant’Andrea University Hospital, 00189 Rome, Italy
5
Nuclear Medicine Unit, ENETS Center of Excellence, Sant’Andrea University Hospital, 00189 Rome, Italy
6
Radiology Unit, ENETS Center of Excellence, Sant’Andrea University Hospital, 00189 Rome, Italy
7
Department of Medical-Surgical Sciences and Translational Medicine, “Sapienza” University of Rome, 00189 Rome, Italy
8
Surgery Unit, ENETS Center of Excellence, Sant’Andrea University Hospital, 00189 Rome, Italy
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2019, 8(6), 910; https://doi.org/10.3390/jcm8060910
Received: 27 May 2019 / Revised: 20 June 2019 / Accepted: 21 June 2019 / Published: 25 June 2019
(This article belongs to the Special Issue Advances in Diagnosis and Therapy of Neuroendocrine Neoplasms)
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Abstract

Purpose: Multidisciplinary approach is widely advised for an effective care of patients with neuroendocrine neoplasia (NEN). Since data on efficacy of multidisciplinary management of NENs patients in referral centers are scanty, this study aimed at analyzing the modality of presentation and clinical outcome of patients with NENs managed by a dedicated multidisciplinary team. Methods. In this prospective observational study, we included all consecutive new patients visiting the Sant’Andrea Hospital in Rome (ENETS—Center of Excellence) between January 2014 and June 2018. Results. A total of 195 patients were evaluated. The most frequent sites were pancreas (38.5%), small bowel (22%), and lung (9.7%). Median Ki67 was 3%. After the first visit at the center, additional radiological and/or nuclear medicine procedures were requested in 163 patients (83.6%), whereas histological data revision was advised in 84 patients (43.1%) (revision of histological slides: 27.7%, new bioptic sampling: 15.4%). After that, disease imaging staging and grading was modified in 30.7% and 17.9% of patients, respectively. Overall, a change in therapeutic management was proposed in 98 patients (50.3%). Conclusions. Multidisciplinary approach in a dedicated team may lead to change of disease imaging staging and grading in a significant proportion of patients. Enhancing referral routes to dedicated-NEN center should be promoted, since it may improve patients’ clinical outcome. View Full-Text
Keywords: neuroendocrine tumors; multidisciplinary; management; outcome; grading; staging neuroendocrine tumors; multidisciplinary; management; outcome; grading; staging
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Magi, L.; Mazzuca, F.; Rinzivillo, M.; Arrivi, G.; Pilozzi, E.; Prosperi, D.; Iannicelli, E.; Mercantini, P.; Rossi, M.; Pizzichini, P.; Laghi, A.; Signore, A.; Marchetti, P.; Annibale, B.; Panzuto, F. Multidisciplinary Management of Neuroendocrine Neoplasia: A Real-World Experience from a Referral Center. J. Clin. Med. 2019, 8, 910.

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