Guidelines for the management of gastroenteropancreatic neuroendocrine (including carcinoid) tumours

Ramage, J. K., Davies, A. H. G., Ardill, J., Bax, N., Caplin, M., Grossman, A., Hawkins, R., McNicol, A. M., Reed, N., Sutton, R., Thakker, R., Aylwin, S., Breen, D. and et al (2005) Guidelines for the management of gastroenteropancreatic neuroendocrine (including carcinoid) tumours. Gut, 54 Supp. 4: iv1-iv16. doi:10.1136/gut.2004.053314

Author Ramage, J. K.
Davies, A. H. G.
Ardill, J.
Bax, N.
Caplin, M.
Grossman, A.
Hawkins, R.
McNicol, A. M.
Reed, N.
Sutton, R.
Thakker, R.
Aylwin, S.
Breen, D.
et al
Title Guidelines for the management of gastroenteropancreatic neuroendocrine (including carcinoid) tumours
Journal name Gut   Check publisher's open access policy
ISSN 0017-5749
Publication date 2005
Year available 2005
Sub-type Article (original research)
DOI 10.1136/gut.2004.053314
Volume 54
Issue Supp. 4
Start page iv1
End page iv16
Total pages 16
Place of publication London, United Kingdom
Publisher BMJ
Language eng
Subject 11 Medical and Health Sciences
1199 Other Medical and Health Sciences
Abstract Genetics Clinical examination to exclude complex cancer syndromes (for example, multiple endocrine neoplasia 1 (MEN1)) should be performed in all cases of neuroendocrine tumours (NETs), and a family history taken (grade C). In all cases where there is a family history of carcinoids or NET, or a second endocrine tumour, a familial syndrome should be suspected (grade C). Individuals with sporadic or familial bronchial or gastric carcinoid should have a family history evaluation and consideration of testing for germline MEN1 mutations. Management of MEN1 families includes screening for endocrine parathyroid and enteropancreatic tumours from late childhood, with predictive testing for first degree relatives of known mutation carriers (grade C). All patients should be evaluated for second endocrine tumours and possibly for other gut cancers (grade C) Diagnosis If a patient presents with symptoms suspicious of a gastroenteropancreatic NET: baseline tests should include chromogranin A (CgA) and 5-hydroxy indole acetic acid (5-HIAA) (grade C). Others that may be appropriate include thyroid function tests (TFTs), parathyroid hormone (PTH), calcium, calcitonin, prolactin, α-fetoprotein, carcinoembryonic antigen (CEA), and β-human chorionic gonadotrophin (β-HCG) (grade D); specific biochemical tests should be requested depending on which syndrome is suspected (see table 4). Imaging For detecting the primary tumour, a multimodality approach is best and may include computed tomography (CT), magnetic resonance imaging (MRI), somatostatin receptor scintigraphy (SSRS), endoscopic ultrasound (EUS), endoscopy, digital subtraction angiography (DSA), and venous sampling (grade B/C). For assessing secondaries, SSRS is the most sensitive modality (grade B). When a primary has been resected, SSRS may be indicated for follow up1 (grade D). Therapy The extent of the tumour, its metastases, and secretory profile should be determined as far as possible before planning treatment (grade C). Surgery should be offered to patients who are fit and have limited disease—that is, primary±regional lymph nodes (grade C).
Keyword Management
Neuroendocrine tumours
Carcinoid tumor
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Unknown

Document type: Journal Article
Sub-type: Article (original research)
Collections: Excellence in Research Australia (ERA) - Collection
School of Medicine Publications
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Created: Wed, 16 Dec 2009, 10:01:19 EST by Macushla Boyle on behalf of Faculty Of Health Sciences