open access
Polski
Colorectal neuroendocrine neoplasms — management guidelines (recommended by the Polish Network of Neuroendocrine Tumours)
Affiliations- Klinika Onkologii i Hematologii, Centralny Szpital Kliniczny Ministerstwa Spraw Wewnętrznych i Administracji, Warszawa, Wołoska 137, 02-507 Warszawa, Poland
- Klinika Endokrynologii, Chorób Metabolicznych i Chorób Wewnętrznych, Pomorski Uniwersytet Medyczny, ul. Unii Lubelskiej 1, 71-252 Szczecin, Poland
open access
Abstract
Neuroendocrine neoplasms/tumours (NENs/NETs) of the large intestine are detected increasingly often, especially rectal tumours, which is probably associated with the widespread use of screening colonoscopy. There is a growing body of evidence supporting the thesis that the NENs of the rectum and the NENs of the colon are two different diseases. Rectal NENs are usually small lesions, of low to moderate histological malignancy, associated with good prognosis, and most may be treated endoscopically. NENs of the colon, however, are often aggressive, poorly differentiated, associated with a poor or uncertain prognosis, and require surgical treatment. The management guidelines regarding these groups of patients are constantly changing. On the basis of the recent literature data and conclusions reached by the working meeting of the Polish Network of Neuroendocrine Tumours (December 2016), this study completes and updates the data and management guidelines regarding colorectal NENs published in Endokrynologia Polska 2013; 64: 358–368.
Abstract
Neuroendocrine neoplasms/tumours (NENs/NETs) of the large intestine are detected increasingly often, especially rectal tumours, which is probably associated with the widespread use of screening colonoscopy. There is a growing body of evidence supporting the thesis that the NENs of the rectum and the NENs of the colon are two different diseases. Rectal NENs are usually small lesions, of low to moderate histological malignancy, associated with good prognosis, and most may be treated endoscopically. NENs of the colon, however, are often aggressive, poorly differentiated, associated with a poor or uncertain prognosis, and require surgical treatment. The management guidelines regarding these groups of patients are constantly changing. On the basis of the recent literature data and conclusions reached by the working meeting of the Polish Network of Neuroendocrine Tumours (December 2016), this study completes and updates the data and management guidelines regarding colorectal NENs published in Endokrynologia Polska 2013; 64: 358–368.
Keywords
colorectal neuroendocrine neoplasms; epidemiology; diagnosis; treatment; follow-up
About this articleTitle
Colorectal neuroendocrine neoplasms — management guidelines (recommended by the Polish Network of Neuroendocrine Tumours)
Journal
Issue
Article type
Review paper
Pages
250-260
Published online
2017-05-08
Page views
5717
Article views/downloads
16222
DOI
Pubmed
Bibliographic record
Endokrynol Pol 2017;68(2):250-260.
Keywords
colorectal neuroendocrine neoplasms
epidemiology
diagnosis
treatment
follow-up
Authors
Teresa Starzyńska
Magdalena Londzin-Olesik
Agata Bałdys-Waligórska
Tomasz Bednarczuk
Jolanta Blicharz-Dorniak
Marek Bolanowski
Agnieszka Boratyn-Nowicka
Małgorzata Borowska
Andrzej Cichocki
Jarosław B. Ćwikła
Andrzej Deptała
Massimo Falconi
Wanda Foltyn
Daria Handkiewicz-Junak
Alicja Hubalewska-Dydejczyk
Barbara Jarząb
Roman Junik
Dariusz Kajdaniuk
Grzegorz Kamiński
Agnieszka Kolasińska-Ćwikła
Aldona Kowalska
Robert Król
Leszek Królicki
Jolanta Kunikowska
Katarzyna Kuśnierz
Paweł Lampe
Dariusz Lange
Anna Lewczuk-Myślicka
Andrzej Lewiński
Michał Lipiński
Bogdan Marek
Anna Nasierowska-Guttmejer
Ewa Nowakowska-Duława
Joanna Pilch-Kowalczyk
Piotr Remiszewski
Violetta Rosiek
Marek Ruchała
Lucyna Siemińska
Anna Sowa-Staszczak
Katarzyna Steinhof-Radwańska
Janusz Strzelczyk
Krzysztof Sworczak
Anhelli Syrenicz
Andrzej Szawłowski
Marek Szczepkowski
Ewa Wachuła
Wojciech Zajęcki
Anna Zemczak
Wojciech Zgliczyński
Beata Kos-Kudła
References (68)- Regula J, Rupinski M, Kraszewska E, et al. Colonoscopy in colorectal-cancer screening for detection of advanced neoplasia. N Engl J Med. 2006; 355(18): 1863–1872.
- Modlin IM, Lye KD, Kidd M. A 5-decade analysis of 13,715 carcinoid tumors. Cancer. 2003; 97(4): 934–959.
- Modlin IM, Latich I, Kidd M, et al. Current status of gastrointestinal carcinoids. Gastroenterology. 2005; 128(6): 1717–1751.
- Tichansky DS, Cagir B, Borrazzo E, et al. Risk of second cancers in patients with colorectal carcinoids. Dis Colon Rectum. 2002; 45(1): 91–97.
- Bogacka B, Marlicz W, Białek A, et al. Trends in colorectal neuroendocrine tumors: A 10 years review. Gut. 2009; 58: A296.
- Kamiński MF, Polkowski M, Reguła J et al. Prevalence and endoscopic features of rectal neuro-endocrine tumours among 50 148 participants of the Polish Colorectal-Cancer Screening Pro-gramme. Gut 2007; 56: A 310.
- Caplin M, Sundin A, Nillson O, et al. Barcelona Consensus Conference participants. ENETS Consensus Guidelines for the management of patients with digestive neuroendocrine neoplasms: colorectal neuroendocrine neoplasms. Neuroendocrinology. 2012; 95(2): 88–97.
- Starzyńska T, Deptała A, Królicki L, et al. Consensus Conference, Polish Network of Neuroendocrine Tumours. Colorectal neuroendocrine neoplasms - management guidelines (recommended by the Polish Network of Neuroendocrine Tumours). Endokrynol Pol. 2013; 64(6): 494–504.
- Ramage JK, De Herder WW, Delle Fave G, et al. Vienna Consensus Conference participants. ENETS Consensus Guidelines Update for Colorectal Neuroendocrine Neoplasms. Neuroendocrinology. 2016; 103(2): 139–143.
- Shim KN, Yang SK, Myung SJ, et al. Atypical endoscopic features of rectal carcinoids. Endoscopy. 2004; 36(4): 313–316.
- Taghavi S, Jayarajan SN, Powers BD, et al. Examining rectal carcinoids in the era of screening colonoscopy: a surveillance, epidemiology, and end results analysis. Dis Colon Rectum. 2013; 56(8): 952–959.
- Park CS, Lee SiH, Kim SB, et al. Multiple rectal neuroendocrine tumors: report of five cases. Korean J Gastroenterol. 2014; 64(2): 103–109.
- Yao JC, Hassan M, Phan A, et al. One hundred years after "carcinoid": epidemiology of and prognostic factors for neuroendocrine tumors in 35,825 cases in the United States. J Clin Oncol. 2008; 26(18): 3063–3072.
- Mełeń-Mucha G, Mucha S, Komorowski J. Early detection of gastric GIST tumor in a patient with rectal neuroendocrine cancer — a case report. 8th Annual ENETS Conference for the Diag-nosis and Treatment of Neuroendocrine Tumor Disease, 9–11 March 2011, Lisbon, Portugal. Neu-roendocrinology 2011; 94 (supl. 1): 36–37.
- Kölby L, Bernhardt P, Swärd C, et al. Chromogranin A as a determinant of midgut carcinoid tumour volume. Regul Pept. 2004; 120(1-3): 269–273.
- Davidson ED, McDougal WS. Elevated serum acid phosphatase levels with rectal carcinoid tumor. Gastroenterology. 1976; 70(1): 114–116.
- Kimura N, Sasano N. Prostate-specific acid phosphatase in carcinoid tumors. Virchows Arch A Pathol Anat Histopathol. 1986; 410(3): 247–251.
- Shi C, Woltering E, Beyer D, et al. Neuroendocrine Tumors of the Colon and Rectum. AJCC Cancer Staging Manual. 2016: 395–406.
- WHO Classification of Tumors of Digestive System. IARC:2017(in press).
- Brierley JD, Gospodarowicz MK, Wittekind C, et al. eds) UICC TNM Classification of Malig-nant Tumours. Eight Edition. Wiley Blackwell. ; 2017: 99–101.
- Fahy BN, Tang LH, Klimstra D, et al. Carcinoid of the rectum risk stratification (CaRRS): a strategy for preoperative outcome assessment. Ann Surg Oncol. 2007; 14(2): 396–404.
- Eliakim R, Yassin K, Niv Y, et al. Prospective multicenter performance evaluation of the second-generation colon capsule compared with colonoscopy. Endoscopy. 2009; 41(12): 1026–1031.
- Hawes RH, Fockens P, Varadarajulu S. Endosonography. Saunders Elsevier. 2015.
- Fu KI, Mashimo Y, Matsuda T, et al. Is endoscopic ultrasonography necessary for depth evaluation of rectal carcinoid tumors <or=10 mm? Dis Colon Rectum. 2006; 49(8): 1238–9; author reply 1239.
- Regge D, Laudi C, Galatola G, et al. Diagnostic accuracy of computed tomographic colonography for the detection of advanced neoplasia in individuals at increased risk of colorectal cancer. JAMA. 2009; 301(23): 2453–2461.
- Koopmans KP, Neels OC, Kema IP, et al. Improved staging of patients with carcinoid and islet cell tumors with 18F-dihydroxy-phenyl-alanine and 11C-5-hydroxy-tryptophan positron emission tomography. J Clin Oncol. 2008; 26(9): 1489–1495.
- Binderup T, Knigge U, Loft A, et al. 18F-fluorodeoxyglucose positron emission tomography predicts survival of patients with neuroendocrine tumors. Clin Cancer Res. 2010; 16(3): 978–985.
- Zieliński T, Przywózka A, Szczepkowski M. Przezodbytowa mikrochirurgia endoskopowa. Chirurgia po Dyplomie. 2013; 10: 12–17.
- Kim HR, Lee WY, Jung KUk, et al. Transanal endoscopic microsurgery for the treatment of well-differentiated rectal neuroendocrine tumors. J Korean Soc Coloproctol. 2012; 28(4): 201–204.
- Wu J, Srirajaskanthan R, Ramage J. Rectal neuroendocrine tumor. Dig Endosc. 2014; 26(4): 532–533.
- Szczepkowski M, Banasiewicz T, Krokowicz P, et al. Polski Konsensus w sprawie stomii pro-tekcyjnej, Pol. Przeg Chir. 2014; 86: 717–741.
- Ni SJ, Sheng WQ, Du X. Pathologic research update of colorectal neuroendocrine tumors. World J Gastroenterol. 2010; 16(14): 1713–1719.
- Jernman J, Hagström J, Mäenpää H, et al. Expression of Stem Cell-associated Marker HES77 in Rectal Neuroendocrine Tumors. Anticancer Res. 2015; 35(7): 3767–3772.
- Gleeson FC, Levy MJ, Dozois EJ, et al. Endoscopically identified well-differentiated rectal carcinoid tumors: impact of tumor size on the natural history and outcomes. Gastrointest Endosc. 2014; 80(1): 144–151.
- McDermott FD, Heeney A, Courtney D, et al. Rectal carcinoids: a systematic review. Surg Endosc. 2014; 28(7): 2020–2026.
- Shigeta K, Okabayashi K, Hasegawa H, et al. Long-term outcome of patients with locally resected high- and low-risk rectal carcinoid tumors. J Gastrointest Surg. 2014; 18(4): 768–773.
- Al-Jiffry BO, Al-Malki O. Neuroendocrine small cell rectal cancer metastasizing to the liver: a unique treatment strategy, case report, and review of the literature. World J Surg Oncol. 2013; 11: 153.
- Lee DS, Jeon SW, Park SY, et al. The feasibility of endoscopic submucosal dissection for rectal carcinoid tumors: comparison with endoscopic mucosal resection. Endoscopy. 2010; 42(8): 647–651.
- Sung HY, Kim SW, Kang WK, et al. Long-term prognosis of an endoscopically treated rectal neuroendocrine tumor: 10-year experience in a single institution. Eur J Gastroenterol Hepatol. 2012; 24(8): 978–983.
- Suzuki S, Ishii N, Uemura M et al. Endoscopic submucosal dissection (ESD) for gastrointesti-nal carcinoid tumors. Surg Endosc 2012; 26: 759–763.
- Lee EJ, Lee JB, Lee SH, et al. Endoscopic submucosal dissection for colorectal tumors--1,000 colorectal ESD cases: one specialized institute's experiences. Surg Endosc. 2013; 27(1): 31–39.
- Kim JiH, Baek IlH, Kim KOh, et al. Usefulness and feasibility of endoscopic submucosal dissection for colorectal tumor: a nationwide multicenter retrospective study in Korea. J Gastrointest Oncol. 2016; 7(6): 924–930.
- Al Natour RH, Saund MS, Sanchez VM, et al. Tumor size and depth predict rate of lymph node metastasis in colon carcinoids and can be used to select patients for endoscopic resection. J Gastrointest Surg. 2012; 16(3): 595–602.
- Pavel M, O'Toole D, Costa F, et al. Vienna Consensus Conference participants. ENETS Consensus Guidelines Update for the Management of Distant Metastatic Disease of Intestinal, Pancreatic, Bronchial Neuroendocrine Neoplasms (NEN) and NEN of Unknown Primary Site. Neuroendocrinology. 2016; 103(2): 172–185.
- Caplin A, Ruszniewski P, Pavel M, et al. A rondomized double-blind, placebo controlled study with lanreotide antyproliferative response in patients with gastroneteropancreatic neuroendocrine tumors (CLARINET) Eur J Cancer. 2013; 49(supl. 3): S3.
- Castellano D, Bajetta E, Panneerselvam A, et al. RADIANT-2 Study Group. Everolimus plus octreotide long-acting repeatable in patients with colorectal neuroendocrine tumors: a subgroup analysis of the phase III RADIANT-2 study. Oncologist. 2013; 18(1): 46–53.
- Yao JC, Fazio N, Singh S, et al. RAD001 in Advanced Neuroendocrine Tumours, Fourth Trial (RADIANT-4) Study Group. Lancet. 2016; 387: 968–77.
- Moertel C, Kvols L, O'Connell M, et al. Treatment of neuroendocrine carcinomas with combined etoposide and cisplatin. Evidence of major therapeutic activity in the anaplastic variants of these neoplasms. Cancer. 1991; 68(2): 227–232, doi: 10.1002/1097-0142(19910715)68:2<227::aid-cncr2820680202>3.0.co;2-i.
- Mitry E, Baudin E, Ducreux M, et al. Treatment of poorly differentiated neuroendocrine tumours with etoposide and cisplatin. Br J Cancer. 1999; 81(8): 1351–1355.
- Hadoux J, Malka D, Planchard D, et al. Post-first-line FOLFOX chemotherapy for grade 3 neuroendocrine carcinoma. Endocr Relat Cancer. 2015; 22(3): 289–298.
- Bajetta E, Catena L, Procopio G, et al. Are capecitabine and oxaliplatin (XELOX) suitable treatments for progressing low-grade and high-grade neuroendocrine tumours? Cancer Chemother Pharmacol. 2007; 59(5): 637–642.
- Hentic O, Hammel P, Couvelard A, et al. FOLFIRI regimen: an effective second-line chemotherapy after failure of etoposide-platinum combination in patients with neuroendocrine carcinomas grade 3. Endocr Relat Cancer. 2012; 19(6): 751–757.
- Welin S, Sorbye H, Sebjornsen S, et al. Clinical effect of temozolomide-based chemotherapy in poorly differentiated endocrine carcinoma after progression on first-line chemotherapy. Cancer. 2011; 117(20): 4617–4622.
- Olsen IH, Sørensen JB, Federspiel B, et al. Temozolomide as second or third line treatment of patients with neuroendocrine carcinomas. ScientificWorldJournal. 2012; 2012: 170496.
- Koumarianou A, Kaltsas G, Kulke MH, et al. Temozolomide in Advanced Neuroendocrine Neoplasms: Pharmacological and Clinical Aspects. Neuroendocrinology. 2015; 101(4): 274–288.
- Mitry E, Walter T, Baudin E, et al. Bevacizumab plus capecitabine in patients with progressive advanced well-differentiated neuroendocrine tumors of the gastro-intestinal (GI-NETs) tract (BETTER trial)--a phase II non-randomised trial. Eur J Cancer. 2014; 50(18): 3107–3115.
- Villard L, Romer A, Marincek N, et al. Cohort study of somatostatin-based radiopeptide therapy with [(90)Y-DOTA]-TOC versus [(90)Y-DOTA]-TOC plus [(177)Lu-DOTA]-TOC in neuroendocrine cancers. J Clin Oncol. 2012; 30(10): 1100–1106.
- Cwikla JB, Sankowski A, Seklecka N, et al. Efficacy of radionuclide treatment DOTATATE Y-90 in patients with progressive metastatic gastroenteropancreatic neuroendocrine carcinomas (GEP-NETs): a phase II study. Ann Oncol. 2010; 21(4): 787–794.
- Kwekkeboom DJ, de Herder WW, van Eijck CHJ, et al. Peptide receptor radionuclide therapy in patients with gastroenteropancreatic neuroendocrine tumors. Semin Nucl Med. 2010; 40(2): 78–88.
- Bodei L, Cremonesi M, Grana CM, et al. Peptide receptor radionuclide therapy with ¹⁷⁷Lu-DOTATATE: the IEO phase I-II study. Eur J Nucl Med Mol Imaging. 2011; 38(12): 2125–2135.
- Kunikowska J, Królicki L, Hubalewska-Dydejczyk A, et al. Clinical results of radionuclide therapy of neuroendocrine tumours with 90Y-DOTATATE and tandem 90Y/177Lu-DOTATATE: which is a better therapy option? Eur J Nucl Med Mol Imaging. 2011; 38(10): 1788–1797.
- Sowa-Staszczak A, Pach D, Kunikowska J, et al. Efficacy and safety of 90Y-DOTATATE therapy in neuroendocrine tumours. Endokrynol Pol. 2011; 62(5): 392–400.
- Pach D, Sowa-Staszczak A, Kunikowska J, et al. Repeated cycles of peptide receptor radionuclide therapy (PRRT)--results and side-effects of the radioisotope 90Y-DOTA TATE, 177Lu-DOTA TATE or 90Y/177Lu-DOTA TATE therapy in patients with disseminated NET. Radiother Oncol. 2012; 102(1): 45–50.
- Kunikowska J, Królicki L, Sowa-Staszczak A, et al. Polish experience in Peptide receptor radionuclide therapy. Recent Results Cancer Res. 2013; 194: 467–478.
- Kunikowska J, Królicki L, Sowa-Staszczak A, et al. Nephrotoxicity after PRRT - still a serious clinical problem? Renal toxicity after peptide receptor radionuclide therapy with 90Y-DOTATATE and 90Y/177Lu-DOTATATE. Endokrynol Pol. 2013; 64(1): 13–20.
- Vinjamuri S, Gilbert TM, Banks M, et al. Peptide receptor radionuclide therapy with (90)Y-DOTATATE/(90)Y-DOTATOC in patients with progressive metastatic neuroendocrine tumours: assessment of response, survival and toxicity. Br J Cancer. 2013; 108(7): 1440–1448.
- Bodei L, Mueller-Brand J, Baum RP, et al. The joint IAEA, EANM, and SNMMI practical guidance on peptide receptor radionuclide therapy (PRRNT) in neuroendocrine tumours. Eur J Nucl Med Mol Imaging. 2013; 40(5): 800–816.
- OCEBM Levels of Evidence Working Group*. “The Oxford 2011 Levels of Evidence”. Oxford Centre for Evidence-Based Medicine. http://www.cebm.net/ index.aspx?o=5653.
