Appearance
Critical updates in neuroendocrine tumors: Version 9 American Joint Committee on Cancer staging system for gastroenteropancreatic neuroendocrine tumors.
Literature Information
| DOI | 10.3322/caac.21840 |
|---|---|
| PMID | 38685134 |
| Journal | CA: a cancer journal for clinicians |
| Impact Factor | 232.4 |
| JCR Quartile | Q1 |
| Publication Year | 2024 |
| Times Cited | 19 |
| Keywords | American Joint Committee on Cancer (AJCC) version 9, cancer staging protocols, gastroenteropancreatic neuroendocrine tumors, gastrointestinal neuroendocrine tumor, pancreatic neuroendocrine tumor |
| Literature Type | Journal Article, Review |
| ISSN | 0007-9235 |
| Pages | 359-367 |
| Issue | 74(4) |
| Authors | Aman Chauhan, Kelley Chan, Thorvardur R Halfdanarson, Andrew M Bellizzi, Guido Rindi, Dermot O'Toole, Phillip S Ge, Dhanpat Jain, Arvind Dasari, Daniel A Anaya, Emily Bergsland, Erik Mittra, Alice C Wei, Thomas A Hope, Ayse T Kendi, Samantha M Thomas, Sherlonda Flem, James Brierley, Elliot A Asare, Kay Washington, Chanjuan Shi |
TL;DR
The AJCC staging system for gastroenteropancreatic neuroendocrine tumors (GEP-NETs) has been updated to incorporate new classifications and advancements in diagnostic and therapeutic technologies, distinguishing grade 3 GEP-NETs from poorly differentiated neuroendocrine carcinoma and recommending against the use of serum chromogranin A for diagnosis and monitoring. This revision emphasizes the growing importance of endoscopic techniques in managing GEP-NETs and introduces a new staging category, highlighting the need for ongoing collaboration among experts to refine cancer staging definitions.
Search for more papers on MaltSci.com
American Joint Committee on Cancer (AJCC) version 9 · cancer staging protocols · gastroenteropancreatic neuroendocrine tumors · gastrointestinal neuroendocrine tumor · pancreatic neuroendocrine tumor
Abstract
The American Joint Committee on Cancer (AJCC) staging system for all cancer sites, including gastroenteropancreatic neuroendocrine tumors (GEP-NETs), is meant to be dynamic, requiring periodic updates to optimize AJCC staging definitions. This entails the collaboration of experts charged with evaluating new evidence that supports changes to each staging system. GEP-NETs are the second most prevalent neoplasm of gastrointestinal origin after colorectal cancer. Since publication of the AJCC eighth edition, the World Health Organization has updated the classification and separates grade 3 GEP-NETs from poorly differentiated neuroendocrine carcinoma. In addition, because of major advancements in diagnostic and therapeutic technologies for GEP-NETs, AJCC version 9 advocates against the use of serum chromogranin A for the diagnosis and monitoring of GEP-NETs. Furthermore, AJCC version 9 recognizes the increasing role of endoscopy and endoscopic resection in the diagnosis and management of NETs, particularly in the stomach, duodenum, and colorectum. Finally, T1NXM0 has been added to stage I in these disease sites as well as in the appendix.
MaltSci.com AI Research Service
Intelligent ReadingAnswer any question about the paper and explain complex charts and formulas
Locate StatementsFind traces of a specific claim within the paper
Add to KBasePerform data extraction, report drafting, and advanced knowledge mining
Primary Questions Addressed
- How do the recent updates in the AJCC staging system impact the treatment protocols for gastroenteropancreatic neuroendocrine tumors?
- What are the implications of separating grade 3 GEP-NETs from poorly differentiated neuroendocrine carcinoma in clinical practice?
- How has the role of endoscopy evolved in the management of neuroendocrine tumors, particularly in light of AJCC version 9 updates?
- What are the challenges associated with the discontinuation of serum chromogranin A for diagnosis and monitoring of GEP-NETs?
- In what ways do the updates in the AJCC staging system reflect the advancements in diagnostic and therapeutic technologies for GEP-NETs?
Key Findings
Research Background and Objectives
The AJCC (American Joint Committee on Cancer) staging system is critical for categorizing various cancers, including gastroenteropancreatic neuroendocrine tumors (GEP-NETs). Given the evolving nature of cancer treatment and diagnosis, periodic updates to the staging definitions are essential. This study aims to review the recent changes to the AJCC staging system for GEP-NETs and highlight the implications of these updates based on new evidence and advancements in medical technology.
Main Methods/Materials/Experimental Design
The review incorporates expert evaluations and consensus on the changes in the AJCC staging system. Key updates from the eighth to the ninth edition are discussed, particularly focusing on the separation of grade 3 GEP-NETs from poorly differentiated neuroendocrine carcinoma, as well as advancements in diagnostic technologies.
Key Results and Findings
- Classification Update: The WHO's revised classification distinguishes grade 3 GEP-NETs from poorly differentiated neuroendocrine carcinoma.
- Diagnostic Changes: AJCC version 9 recommends against using serum chromogranin A for diagnosing and monitoring GEP-NETs.
- Role of Endoscopy: The increased importance of endoscopic techniques for the diagnosis and management of NETs, especially in specific gastrointestinal sites, is acknowledged.
- Staging Revision: Introduction of T1NXM0 into stage I for GEP-NETs in the stomach, duodenum, colorectum, and appendix.
Main Conclusions/Significance/Innovativeness
The updates to the AJCC staging system for GEP-NETs reflect significant advancements in the understanding and management of these tumors. The separation of grade 3 GEP-NETs from poorly differentiated neuroendocrine carcinoma provides clearer diagnostic criteria, while the shift away from serum chromogranin A aligns with current diagnostic practices. Additionally, recognizing the role of endoscopy in management signifies a shift towards less invasive techniques, which may improve patient outcomes.
Research Limitations and Future Directions
- Limitations: The study primarily focuses on the updates without extensive empirical validation of the new recommendations. Future research may be needed to assess the impact of these changes on clinical outcomes.
- Future Directions: Further investigations should explore the long-term implications of these updates on patient management and survival rates, as well as the integration of emerging diagnostic technologies in clinical practice.
| Aspect | Details |
|---|---|
| Classification Update | Grade 3 GEP-NETs separated from poorly differentiated NEC |
| Diagnostic Changes | Serum chromogranin A no longer recommended |
| Role of Endoscopy | Increased emphasis on endoscopic diagnosis and management |
| Staging Revision | T1NXM0 added to stage I for specific sites |
References
- Enterochromaffin-like Cell Hyperplasia-Associated Gastric Neuroendocrine Tumors May Arise in the Setting of Proton Pump Inhibitor Use. - Rehan Rais;Nikolaos A Trikalinos;Jingxia Liu;Deyali Chatterjee - Archives of pathology & laboratory medicine (2022)
- Morphological Factors Related to Nodal Metastases in Neuroendocrine Tumors of the Appendix: A Multicentric Retrospective Study. - Nicole Brighi;Stefano La Rosa;Giulio Rossi;Federica Grillo;Sara Pusceddu;Maria Rinzivillo;Francesca Spada;Salvatore Tafuto;Sara Massironi;Antongiulio Faggiano;Lorenzo Antonuzzo;Donatella Santini;Fausto Sessa;Roberta Maragliano;Fabio Gelsomino;Manuela Albertelli;Claudio Vernieri;Francesco Panzuto;Nicola Fazio;Chiara De Divitiis;Giuseppe Lamberti;Annamaria Colao;Gianfranco Delle Fave;Davide Campana - Annals of surgery (2020)
- Chromogranin A as circulating marker for diagnosis and management of neuroendocrine neoplasms: more flaws than fame. - Vincenzo Marotta;Maria Chiara Zatelli;Concetta Sciammarella;Maria Rosaria Ambrosio;Marta Bondanelli;Annamaria Colao;Antongiulio Faggiano - Endocrine-related cancer (2018)
- Expanding Role of Gastroenterology in the Staging of Digestive Neuroendocrine Tumors: Updates From the American Joint Committee on Cancer Version 9 Cancer Staging System. - Phillip S Ge;Chanjuan Shi;Elliot Asare;Mary Kay Washington;Dermot O'Toole; - Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association (2024)
- The epidemiology of gastroenteropancreatic neuroendocrine tumors. - Ben Lawrence;Bjorn I Gustafsson;Anthony Chan;Bernhard Svejda;Mark Kidd;Irvin M Modlin - Endocrinology and metabolism clinics of North America (2011)
- Epidemiology of Gastric Malignancies 2000-2018 According to Histology: A Population-Based Analysis of Incidence and Temporal Trends. - Sheila D Rustgi;Meg McKinley;Brandon McBay;Haley M Zylberberg;Scarlett L Gomez;Chin Hur;Fay Kastrinos;Samir Gupta;Michelle Kang Kim;Steven H Itzkowitz;Shailja C Shah - Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association (2023)
- The Distal Predilection of Small Bowel Neuroendocrine Tumors. - Kendall J Keck;Jessica E Maxwell;Alan F Utria;Andrew M Bellizzi;Joseph S Dillon;Thomas M O'Dorisio;James R Howe - Annals of surgical oncology (2018)
- Survival and Incidence Patterns of Pancreatic Neuroendocrine Tumors Over the Last 2 Decades: A SEER Database Analysis. - Mohamad Bassam Sonbol;Gina L Mazza;Lanyu Mi;Thomas Oliver;Jason Starr;Hallbera Gudmundsdottir;Sean P Cleary;Timothy Hobday;Thorvardur R Halfdanarson - The oncologist (2022)
- Consensus report of the 2021 National Cancer Institute neuroendocrine tumor clinical trials planning meeting. - Simron Singh;Thomas A Hope;Emily B Bergsland;Lisa Bodei;David L Bushnell;Jennifer A Chan;Beth R Chasen;Aman Chauhan;Satya Das;Arvind Dasari;Jaydira Del Rivero;Ghassan El-Haddad;Karyn A Goodman;Daniel M Halperin;Mark A Lewis;O Wolf Lindwasser;Sten Myrehaug;Nitya P Raj;Diane L Reidy-Lagunes;Heloisa P Soares;Jonathan R Strosberg;Elise C Kohn;Pamela L Kunz; - Journal of the National Cancer Institute (2023)
- Head-to-Head Comparison of 64Cu-DOTATATE and 68Ga-DOTATOC PET/CT: A Prospective Study of 59 Patients with Neuroendocrine Tumors. - Camilla B Johnbeck;Ulrich Knigge;Annika Loft;Anne K Berthelsen;Jann Mortensen;Peter Oturai;Seppo W Langer;Dennis R Elema;Andreas Kjaer - Journal of nuclear medicine : official publication, Society of Nuclear Medicine (2017)
Literatures Citing This Work
- AJCC Cancer Staging System Version 9: Practice-Informing Updates for Gastroenteropancreatic Neuroendocrine Tumors. - Kelley Chan;Aman Chauhan;Chanjuan Shi - Annals of surgical oncology (2024)
- Pathological Features Associated with Lymph Node Disease in Patients with Appendiceal Neuroendocrine Tumors. - Salvador Rodriguez Franco;Sumaya Abdul Ghaffar;Ying Jin;Reed Weiss;Mona Hamermesh;Andrii Khomiak;Toshitaka Sugawara;Oskar Franklin;Alexis D Leal;Christopher H Lieu;Richard D Schulick;Marco Del Chiaro;Steven Ahrendt;Martin D McCarter;Ana L Gleisner - Cancers (2024)
- Pancreatic Neuroendocrine Neoplasms: Classification and Novel Role of Endoscopic Ultrasound in Diagnosis and Treatment Personalization. - Matteo Tacelli;Stefano Partelli;Massimo Falconi;Paolo Giorgio Arcidiacono;Gabriele Capurso - United European gastroenterology journal (2025)
- NON-FUNCTIONING SPORADIC PANCREATIC NEUROENDOCRINE TUMOR IS AN INDEPENDENT RISK FACTOR FOR RECURRENCE AFTER SURGICAL TREATMENT. - Estela Regina Ramos Figueira;André Luis Montagnini;Jessica Okubo;Ana Gabriela Vivarelli Fernandes;Marina Alessandra Pereira;Ulysses Ribeiro Junior;Paulo Herman;José Jukemura - Arquivos brasileiros de cirurgia digestiva : ABCD = Brazilian archives of digestive surgery (2025)
- Development and validation of predictive models for distant metastasis and prognosis of gastroenteropancreatic neuroendocrine neoplasms. - Xuan-Peng Zhou;Luan-Biao Sun;Wen-Hao Liu;Xin-Yuan Song;Yang Gao;Jian-Peng Xing;Shuo-Hui Gao - Scientific reports (2025)
- Duodenal neuroendocrine tumours masquerading as peptic duodenitis, crushed lymphoid aggregates and prominent Brunner glands: some diagnostic pitfalls. - Lena Hasson;Dipti M Karamchandani - Histopathology (2025)
- Clinicopathological Correlates of Hormone Expression-Based Subtypes of Non-Functioning Duodenal/Ampullary Neuroendocrine Tumors: A Multicenter Study of 151 Cases. - Alessandro Vanoli;Nestor Piva;Frediano Socrate Inzani;Federica Grillo;Catherine Klersy;Silvia Uccella;Paola Spaggiari;Luca Albarello;Marco Schiavo Lena;Massimo Milione;Caterina Antoniacomi;Anna Caterina Milanetto;Alessandro Zerbi;Antonio Di Sabatino;Massimo Falconi;Andrea Anderloni;Paola Mattiolo;Claudio Luchini;Aldo Scarpa;Matteo Fassan;Paola Parente;Ombretta Luinetti;Guido Rindi;Marco Paulli;Stefano La Rosa - Endocrine pathology (2025)
- Machine learning predicts prognosis in patients with gastroenteropancreatic neuroendocrine tumors with liver metastases. - Fuli Gao;Jian Chen;Xiaodan Xu - Discover oncology (2025)
- Metabolic changes in neuroendocrine neoplasms. - Chunhua Hu;Lingyi Chen;Yi Ding;Mujie Ye;Qiyun Tang - Cellular and molecular life sciences : CMLS (2025)
- Prognosis of NETs: Has There Been Improvement over the Last 30 Years? - Dominique Clement;Debashis Sarker;Aviva Frydman;Andrzej Rak;Vina Soran;David C Llewellyn;Raj Srirajaskanthan - Neuroendocrinology (2025)
... (9 more literatures)
© 2025 MaltSci - We reshape scientific research with AI technology