High grade neuroendocrine carcinoma

amarh

hi my mom has just been dignosed with high grade neuroendocrine carcinoma...every thing i have read is very scary... Can some one pls advise what to expect.

Deathorglory

Hello amarh

Hello amarh,

I'm sorry to hear about your mother.  I don't know anything about high grade neuroendocrine carcinoma, but a quick Google search scared me as well.  I don't know that the espohageal cancer board is going to be of very much help for you.  I hope for your sake that someone here knows something useful to share.  

Wishing the best for you & your Mom,

Ed

LorettaMarshall

Armah~positive info re neuroendocrine tumors difficult to find!

Good morning Amarh:

First let me express my supreme sorrow that another “mom” has been diagnosed with any kind of cancer.  Having grown up hearing so often, “The hand that rocks the cradle rules the world” actually gave supreme honor to “moms”.  There is a reverence and respect and love for our moms that it can’t be put into words.  And then to hear the word “cancer” of any kind, threatens our own emotional stability.  My own mom went to be with the Lord in 2013, and so often during each day, I find myself doing something the same way my mom did it, or wondering, “Now what would mama say or do.”  That said, all I can do is know that you feel the same way about your mother.  Further, I do wish there was something that I could do that would give you more information about “high grade neuroendocrine tumors.”  As if my custom, I try to find articles that relate to the subject at hand.  I will tell you that in my many years observing this particular site, I can remember only one case of an endocrine tumor on this particular Esophageal Cancer topic forum being discussed.  Others here may know more than I.  If so, I hope they will answer you.  As I read about endocrine tumors, I see that they can be found in more than one organ. 

Therefore, all I know to do is to provide you with references I’ve found on the web, and no doubt you have already read many of them yourself.  So all I can say is, I’m truly sorry to hear about your mom, and sorry that I can’t offer you any helpful information. 

Sincerely sad about your mom,

Loretta

P.S.  I find the last of these references (#6) to be the most positive although I’m not overly-optimistic with any of them, sorry to say.  This report was released in January of 2017. 

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1.  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3124459/?log$=activity

“…Since neuroendocrine cells are distributed widely throughout the body, neuroendocrine neoplasms can occur in various organs. High-grade neuroendocrine carcinomas can originate for example in the gastrointestinal tract, bladder, cervix or prostate. Cho et al. [4] reviewed prospectively maintained databases from two institutions of patients who underwent hepatic resection for neuroendocrine neoplasms between 1990 and 2006. Only 10% of 70 patients had high-grade disease. The patient in this case report was diagnosed on histopathological examination as neuroendocrine carcinoma originating from the liver. In addition, the tumor was more aggressive than most neuroendocrine carcinomas (the MIB-1 index was about 70%), and was classified as high-grade neuroendocrine carcinoma. Systemic surveys revealed no other primary site. This diagnosis is thought to be correct because the patient has shown no evidence of another primary site of neuroendocrine carcinoma over two years from diagnosis…”

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2.       https://www.nanets.net/

“…NANETS is a medical society established by healthcare professionals dedicated to advancing the field of neuroendocrine tumor (NET) disease management.  Each year, NANETS brings physicians, researchers, allied healthcare providers and medical students together through its international symposia, regional medical conferences and publications focused on neuroendocrine research and education. NANETS Annual Symposium is the largest professional NET disease meeting of medical professionals in North America…”

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3.      https://www.nanets.net/content/high-grade-poorly-differentiated-neuroendocrine-tumors

• Home   Current Clinical Trials

High Grade (Poorly-Differentiated) Neuroendocrine Tumors

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4.      https://www.ncbi.nlm.nih.gov/pubmed/21327890/

“Future perspectives on neuroendocrine tumors…  Abstract

In the last 30 years the incidence and prevalence of gastroenteropancreatic neuroendocrine tumors (GEP-NETs) has increased substantially. This could be partly due to improvements in diagnostic imaging, which lead to the incidental diagnosis of asymptomatic cases. However, despite these improvements, patients typically experience long delays before they are diagnosed.

In this review, we discuss both the limitations and advances in our understanding of the pathogenesis, molecular and cellular biology, diagnosis, classification, staging, and treatment of GEP-NETs in order to identify which factors could be contributing to the delay in diagnosis and timely treatment of these patients. Within this context, the results from the most relevant clinical trials the available targeted therapies for the treatment of GEP-NETs, such as the "RAD001 in Advanced Neuroendocrine Tumors," will be discussed…”

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5.      https://www.ncbi.nlm.nih.gov/pubmed/22510940

“…Neuroendocrine tumors of the digestive tract: impact of new classifications and new agents on therapeutic approaches.

Abstract - PURPOSE OF REVIEW:

Gastroenteropancreatic neuroendocrine tumors (GEP-NETs) constitute a diverse group of neoplasms arising from the diffuse neuroendocrine cell system. During the last 2 years a new classification system, the WHO 2010, has come into clinical practice together with Tumor Nodes Metastases (TNM) staging and grading systems, developed by the European Neuroendocrine Tumor Society/American Joint Cancer Committee. At the same time new targeted agents have been developed for treatment of GEP-NETs and it is important discuss these new agents in relation to the classification and staging system.

RECENT FINDINGS:

The current article is reviewing the most important clinical trials of targeting agents within the field of neuroendocrine tumors. Tyrosine kinase inhibitors as well as PI3 kinase mTOR inhibitors have been applied in the treatment of neuroendocrine tumors.

SUMMARY:

Sunitinib and everolimus have recently been registered for treatment of pancreatic neuroendocrine tumors worldwide. The role of these new targeted agents in the treatment algorithm of neuroendocrine tumors will be discussed. A large number of phase I and phase II trials have been performed in GEP-NETs with rather limited results and no significant impact on the clinical management of patients with GEP-NETs. However, there are two phase III trials that have completely changed the treatment landscape for pancreatic neuroendocrine tumors, e.g., sunitinib and everolimus demonstrating an increased progression free survival of 11 vs. 5 months for the placebo group…”

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6.      https://www.ncbi.nlm.nih.gov/pubmed/28210088

“World J Gastroenterol. 2017 Jan 21;23(3):516-524. doi: 10.3748/wjg.v23.i3.516.

Clinicopathological, treatment, and prognosis study of 43 gastric neuroendocrine carcinomas...

Author information 1  De-Jun Liu, Xue-Liang Fu, Wei Liu, Jun-Feng Zhang, Yan-Miao Huo, Jiao Li, Rong Hua, Yong-Wei Sun, Department Biliary-Pancreatic Surgery, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China.

Abstract

AIM: To provide more information and therapeutic methods about gastric neuroendocrine carcinomas (G-NECs) which occur rarely but are highly malignant and clinically challenging.

METHODS:  We retrospectively analyzed the clinicopathological characteristics, treatments, and prognosis of 43 G-NEC patients at our hospital between January 2007 and December 2014. The diagnosis was based on the 2010 World Health Organization criteria.

RESULTS: Forty-three G-NECs containing 39 small cell carcinomas and 4 large cell NECs with Ki67 > 60% were included in this study, accounting for only 0.95% of all gastric carcinomas.

The median patient age was 62 years (range, 33-82) and the male-to-female ratio was 4.4:1.

All patients underwent surgery, including 38 curative resections and 5 palliative resections.

Among these 43 patients, nearly half (48.84%) of these tumors were located in the cardiac region of the stomach, regional lymph node metastasis was found in 31 cases (72.09%), and liver metastasis was found in 6 cases (13.95%).

Follow-up information was got for 40 patients. Twenty-three die of this disease with a median survival of 31 mo (range 1-90). The 1-year, 2-year, 3-year, and 5-year survival rate was 77.50%, 57.04%, 44.51%, and 35.05%, respectively.

Survival was better in patients with tumor located in the cardiac region of the stomach, less than 7 lymph nodes metastasis and no liver metastasis.

Five patients did not undergo postoperative chemotherapy, and the median survival time for these patients was 15 mo.

For the remaining 34 patients who received postoperative chemotherapy, the median survival time was 44 mo and those received etoposide, cisplatin, and Paclitaxel survived the best.

One patient with resected liver metastasis who received postoperative Capecitabine plus Oxaliplatin and Paclitaxel systemic chemotherapy plus octreotide LAR (30 mg intramuscularly, every 4 wk, for 2 years) has survived for 74 mo with no recurrence.

CONCLUSION:  G-NECs are mostly nonfunctioning, which lead to a delay in detection. Local and/or distant metastases were noticed in most patients when diagnosed, and they required postoperative medical treatment. Adjuvant etoposide, cisplatin plus Paclitaxel systemic chemotherapy is recommended for these patients…”

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