MODERN APPROACHES AND RECENT ADVANCES IN NEUROENDOCRINE TUMORS

Modern Approaches and Recent Advances in Neuroendocrine Tumors-kapak

TREATMENT AND FOLLOW-UP STRATEGIES AFTER RELAPSE IN GEP-NETS

Abdullah Güneş1 Ali Çiftçi2

1Kocaeli City Hospital, Department of General Surgery, Kocaeli, Türkiye

2University of Health Sciences, Derince Training and Research Hospital, Department of General Surgery, Kocaeli, Türkiye

Güneş A, Çiftçi A. Treatment and Follow-Up Strategies After Relapse in GEP-NETs. In: Gönüllü E, Karaman K, editors. Modern Approaches and Recent Advances in Neuroendocrine Tumors. 1st ed. Ankara: Türkiye Klinikleri; 2025. p.175-181.

ABSTRACT

Gastroenteropancreatic neuroendocrine tumors (GEP-NETs) are a group of tumors originating from neuroendocrine cells in the digestive tract and pancreas. The incidence of GEP-NETs has increased in recent years due to advances in diagnostic tools and increased awareness. GEP-NETs are classified into G1, G2, and G3 based on the Ki-67 proliferation index and mitotic count according to the WHO classification. Recurrence is a critical clinical condition that can occur even in slow-progressing tumors, and its management plays a key role in determining the course of the disease and treatment strategies. Recurrence in GEP-NETs significantly impacts disease course and treatment management. Surgical resection is used in local recurrences, debulking surgery and liver transplantation are applied in metastatic foci. Other nonsurgical approaches used in treatment are somatostatin analogs, peptide receptor radionuclide therapy, mTOR inhibitors such as everolimus. Chemotherapy agents such as streptozotocin, temozolomide, cisplatin are also used in some cases. Local treatments such as transarterial chemoembolization (TACE) and radiofrequency ablation (RFA) are used in cases with liver metastases. Early diagnosis and appropriate treatment selection are crucial for improving patient survival and quality of life. A multidisciplinary approach, including oncologists, nutritionists, and psychologists, is essential for the effective treatment and follow-up of GEP-NETs.

Keywords: Neuroendocrine tumor; Recurrence; Neoplasm micrometastasis; Chromogranin A; Cytoreduction surgical procedures

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