What are the ENETS guidelines on the treatment of metastatic pancreatic neuroendocrine tumors (NETs)?

Updated: Dec 23, 2018
  • Author: Evan S Ong, MD, MS; more...
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Answer

Answer

The European Neuroendocrine Tumor Society (ENETS) consensus guidelines are generally similar to those of the NCCN, and include the following recommendations [20] :

  • Surgery with curative intent, and/or loco‐regional or ablative therapies, should be considered at initial diagnosis and in the course of the disease as an alternative to systemic therapies

  • In patients with a functioning NET, all liver-directed therapies require prior initiation of somatostatin analog therapy (or other specific meaures for controlling symptoms)

  • Debulking surgery is indicated to improve symptom control in selected patients with functioning NET with predominant liver disease, even if the liver tumor burden can be reduced by less than 90%

  • Liver transplantation is an option in very highly selected patients, preferably young patients with functional syndromes who experience early resistance to medical therapy.


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