Advances in the Diagnosis and Therapeutic Management of Gastroenteropancreatic Neuroendocrine Neoplasms (GEP-NENs)

SIMPLE SUMMARY: Gastroenteropancreatic neuroendocrine neoplasms (GEP-NENs) are a group of tumors with different clinical manifestations, various localizations in the human body, and a particularly wide range of histological types, grades and severities. Their diagnosis and therapeutic management are complex. Current standards are not always effective, and sometimes require modifications. Thus, knowledge about GEP-NENs and approaches for the treatment of these patients in Europe and all over the world are constantly evolving. The aim of this review is to highlight the progress in diagnostics and treatment of GEP-NENs. Special attention is given to GEP-NETs as the most widely reported in the literature. ABSTRACT: Neuroendocrine neoplasms (NENs) are an increasingly common cause of neoplastic diseases. One of the largest groups of NENs are neoplasms localized to the gastroenteropancreatic system, which are known as gastroenteropancreatic NENs (GEP-NENs). Because of nonspecific clinical symptoms, GEP-NEN patient diagnosis and, consequently, their treatment, might be difficult and delayed. This situation has forced researchers all over the world to continue progress in the diagnosis and treatment of patients with GEP-NENs. Our review is designed to present the latest reports on the laboratory diagnostic techniques, imaging tests and surgical and nonsurgical treatment strategies used for patients with these rare neoplasms. We paid particular attention to the nuclear approach, the use of which has been applied to GEP-NEN patient diagnosis, and to nonsurgical and radionuclide treatment strategies. Recent publications were reviewed in search of reports on new strategies for effective disease management. Attention was also paid to those studies still in progress, but with successful results. A total of 248 papers were analyzed, from which 141 papers most relevant to the aim of the study were selected. Using these papers, we highlight the progress in the development of diagnostic and treatment strategies for patients with GEP-NENs.