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Pancreatic Neoplasms: HELP
Articles by Ulrich Knigge
Based on 18 articles published since 2008
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Between 2008 and 2019, U. Knigge wrote the following 18 articles about Pancreatic Neoplasms.
 
+ Citations + Abstracts
1 Guideline ENETS Consensus Guidelines Update for the Management of Distant Metastatic Disease of Intestinal, Pancreatic, Bronchial Neuroendocrine Neoplasms (NEN) and NEN of Unknown Primary Site. 2016

Pavel, M / O'Toole, D / Costa, F / Capdevila, J / Gross, D / Kianmanesh, R / Krenning, E / Knigge, U / Salazar, R / Pape, U-F / Öberg, K / Anonymous6880853. ·Charite Virchow Klinikum, Berlin, Germany. ·Neuroendocrinology · Pubmed #26731013.

ABSTRACT: -- No abstract --

2 Guideline Nordic guidelines 2014 for diagnosis and treatment of gastroenteropancreatic neuroendocrine neoplasms. 2014

Janson, Eva Tiensuu / Sorbye, Halfdan / Welin, Staffan / Federspiel, Birgitte / Grønbæk, Henning / Hellman, Per / Ladekarl, Morten / Langer, Seppo W / Mortensen, Jann / Schalin-Jäntti, Camilla / Sundin, Anders / Sundlöv, Anna / Thiis-Evensen, Espen / Knigge, Ulrich. ·Department of Medical Sciences, Uppsala University , Uppsala , Sweden * ·Acta Oncol · Pubmed #25140861.

ABSTRACT: BACKGROUND: The diagnostic work-up and treatment of patients with neuroendocrine neoplasms (NENs) has undergone major recent advances and new methods are currently introduced into the clinic. An update of the WHO classification has resulted in a new nomenclature dividing NENs into neuroendocrine tumours (NETs) including G1 (Ki67 index ≤ 2%) and G2 (Ki67 index 3-20%) tumours and neuroendocrine carcinomas (NECs) with Ki67 index > 20%, G3. Aim. These Nordic guidelines summarise the Nordic Neuroendocrine Tumour Group's current view on how to diagnose and treat NEN-patients and are meant to be useful in the daily practice for clinicians handling these patients.

3 Guideline Neuroendocrine gastro-entero-pancreatic tumors: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. 2012

Öberg, K / Knigge, U / Kwekkeboom, D / Perren, A / Anonymous3470737. ·Department of Endocrine Oncology, University Hospital, Uppsala University, Uppsala, Sweden. ·Ann Oncol · Pubmed #22997445.

ABSTRACT: -- No abstract --

4 Guideline Nordic Guidelines 2010 for diagnosis and treatment of gastroenteropancreatic neuroendocrine tumours. 2010

Janson, Eva Tiensuu / Sørbye, Halfdan / Welin, Staffan / Federspiel, Birgitte / Grønbaek, Henning / Hellman, Per / Mathisen, Oystein / Mortensen, Jann / Sundin, Anders / Thiis-Evensen, Espen / Välimäki, Matti J / Oberg, Kjell / Knigge, Ulrich. ·Department of Medical Sciences, Uppsala University, Uppsala, Sweden. Tiensuu_Janson@medsci.uu.se ·Acta Oncol · Pubmed #20553100.

ABSTRACT: The diagnostic work-up and treatment of patients with neuroendocrine tumours has undergone a major change during the last decade. New diagnostic possibilities and treatment options have been developed. These Nordic guidelines, written by a group with a major interest in the subject, summarises our current view on how to diagnose and treat these patients. The guidelines are meant to be useful in the daily practice for clinicians handling patients with neuroendocrine tumours.

5 Review Gastrointestinal Surgery of Neuroendocrine Neoplasms. 2015

Hansen, Carsten Palnæs / Olsen, Ingrid Holst / Knigge, Ulrich. ·Department of Surgical Gastroenterology, Neuroendocrine Tumor Centre of Excellence, Rigshospitalet, Copenhagen, Denmark. ·Front Horm Res · Pubmed #26303710.

ABSTRACT: Surgery is the only treatment that may cure the patient with gastroenteropancreatic (GEP) neuroendocrine neoplasms (NENs) and should always be considered as the first-line treatment if radical resection can be achieved. Even in cases where radical surgery is not possible, palliative resection may be performed to reduce local or hormone-induced symptoms and to improve quality of life. The surgical procedures for GEP-NENs are accordingly described below. In most patients life-long follow-up is required, even following radical surgery, as recurrence may occur several years later.

6 Review Surgery for GEP-NETs. 2012

Knigge, Ulrich / Hansen, Carsten Palnæs. ·Department of Gastrointestinal Surgery C, Neuroendocrine Tumor Centre of Excellence, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark. ulrich.knigge@rh.regionh.dk ·Best Pract Res Clin Gastroenterol · Pubmed #23582921.

ABSTRACT: Surgery is the only treatment that may cure the patient with gastroentero-pancreatic (GEP) neuroendocrine tumours (NET) and neuroendocrine carcinomas (NEC) and should always be considered as first line treatment if R0/R1 resection can be achieved. The surgical and interventional procedures for GEP-NET are accordingly described below. Life-long follow-up should be performed in almost all patients at a specialized NET center.

7 Review Interventional treatment of neuroendocrine liver metastases. 2008

Knigge, U / Hansen, C P / Stadil, F. ·Department of Surgery C Rigshospitalet, Faculty of Health Sciences, University of Copenhagen Copenhagen, Denmark. ulrich.knigge@rh.dk ·Surgeon · Pubmed #18697366.

ABSTRACT: Neuroendocrine gastroenteropancreatic tumours are rare with an incidence of 2-4/100.000 per year. More than 75% of the patients develop hepatic metastases, which reduce the five year survival from 70-80% to 30-40%. In addition to chemo- and biotherapy, interventional therapy of liver metastases should be considered in order to prolong survival and reduce endocrine and local symptoms. Surgical resection is the only curative treatment, but possible in less than 10% of the patients. Curative and palliative resection, which is possible in less than 20-25% of the patients, relieve endocrine and local symptoms in 90% of the patients for more than two years, and the five year survival is prolonged to 40-85%, although metastases recur or progress in almost all patients. Tumour ablation by radiofrequency therapy has a palliative effect on endocrine symptoms in 70-90% of the patients for up to two years, but should not be a substitute for surgical treatment. When metastases are not eligible for surgical treatment or ablation, embolization or chemoembolization are alternative options with a reduction in tumour burden in about 50% and a five year survival of around 60% ofthe patients. The symptomatic response rate is 90% with a mean duration of two years. Liver transplantation should be restricted to very few and highly selected patients without extrahepatic disease. Recurrence is inevitable in nearly all patients.

8 Article Intravenous versus oral etoposide: efficacy and correlation to clinical outcome in patients with high-grade metastatic gastroenteropancreatic neuroendocrine neoplasms (WHO G3). 2018

Ali, Abir Salwa / Grönberg, Malin / Langer, Seppo W / Ladekarl, Morten / Hjortland, Geir Olav / Vestermark, Lene Weber / Österlund, Pia / Welin, Staffan / Grønbæk, Henning / Knigge, Ulrich / Sorbye, Halfdan / Janson, Eva Tiensuu. ·Department of Medical Sciences, Section of Endocrine Oncology, Uppsala University, Uppsala, Sweden. abir.ali@medsci.uu.se. · Department of Medical Sciences, Section of Endocrine Oncology, Uppsala University, Uppsala, Sweden. · Departments of Surgery C and Endocrinology PE, Rigshospitalet, Faculty of Health Science, University of Copenhagen, Copenhagen, Denmark. · Department of Oncology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark. · Department of Oncology, Aarhus University Hospital, Aarhus, Denmark. · Department of Oncology, Oslo University Hospital, Oslo, Norway. · Department of Oncology, Odense University Hospital, Odense, Denmark. · Department of Oncology, Tampere University Hospital and Tampere University, Tampere, Finland. · Department of Oncology, Helsinki University Hospital and Helsinki University, Helsinki, Finland. · Departments of Hepatology and Gastroenterology, Aarhus University Hospital, Aarhus, Denmark. · Department of Oncology, Haukeland University Hospital, Bergen, Norway. ·Med Oncol · Pubmed #29511910.

ABSTRACT: High-grade gastroenteropancreatic neuroendocrine neoplasms (GEP-NENs, G3) are aggressive cancers of the digestive system with poor prognosis and survival. Platinum-based chemotherapy (cisplatin/carboplatin + etoposide) is considered the first-line palliative treatment. Etoposide is frequently administered intravenously; however, oral etoposide may be used as an alternative. Concerns for oral etoposide include decreased bioavailability, inter- and intra-patient variability and patient compliance. We aimed to evaluate possible differences in progression-free survival (PFS) and overall survival (OS) in patients treated with oral etoposide compared to etoposide given as infusion. Patients (n = 236) from the Nordic NEC study were divided into three groups receiving etoposide as a long infusion (24 h, n = 170), short infusion (≤ 5 h, n = 33) or oral etoposide (n = 33) according to hospital tradition. PFS and OS were analyzed with Kaplan-Meier (log-rank), cox proportional hazard ratios and confidence intervals. No statistical differences were observed in PFS or OS when comparing patients receiving long infusion (median PFS 3.8 months, median OS 14.5 months), short infusion (PFS 5.6 months, OS 11.0 months) or oral etoposide (PFS 5.4 months, OS 11.3 months). We observed equal efficacy for the three administration routes suggesting oral etoposide may be safe and efficient in treating high-grade GEP-NEN, G3 patients scheduled for cisplatin/carboplatin + etoposide therapy.

9 Article Expression of p53 protein in high-grade gastroenteropancreatic neuroendocrine carcinoma. 2017

Ali, Abir Salwa / Grönberg, Malin / Federspiel, Birgitte / Scoazec, Jean-Yves / Hjortland, Geir Olav / Grønbæk, Henning / Ladekarl, Morten / Langer, Seppo W / Welin, Staffan / Vestermark, Lene Weber / Arola, Johanna / Österlund, Pia / Knigge, Ulrich / Sorbye, Halfdan / Grimelius, Lars / Janson, Eva Tiensuu. ·Department of Medical Sciences, Section of Endocrine Oncology, Uppsala University, Uppsala, Sweden. · Department of Pathology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark. · Department of Biopathology, Institut Gustave Roussy, Villejuif, France. · Department of Oncology, Oslo University, Oslo, Norway. · Department of Hepatology & Gastroenterology, Aarhus university Hospital, Aarhus, Denmark. · Department of Oncology, Aarhus University Hospital, Aarhus, Denmark. · Department of Oncology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark. · Department of Oncology, Odense University Hospital, Odense, Denmark. · Pathology, HUSLAB, University of Helsinki and Helsinki University Hospital, Helsinki, Finland. · Department of Oncology, Helsinki University Hospital and Helsinki University, Helsinki Finland. · Department of Oncology, Tampere University Hospital, Tampere, Finland. · Department of Surgery C and Endocrinology PE, Rigshospitalet, Faculty of Health Science, University of Copenhagen, Copenhagen, Denmark. · Department of Oncology, Haukeland University Hospital and Department of Clinical Science, University of Bergen, Bergen, Norway. · Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden. ·PLoS One · Pubmed #29112960.

ABSTRACT: BACKGROUND: Gastroenteropancreatic neuroendocrine carcinomas (GEP-NECs) are aggressive, rapidly proliferating tumors. Therapeutic response to current chemotherapy regimens is usually short lasting. The aim of this study was to examine the expression and potential clinical importance of immunoreactive p53 protein in GEP-NEC. MATERIALS AND METHODS: Tumor tissues from 124 GEP-NEC patients with locally advanced or metastatic disease treated with platinum-based chemotherapy were collected from Nordic centers and clinical data were obtained from the Nordic NEC register. Tumor proliferation rate and differentiation were re-evaluated. All specimens were immunostained for p53 protein using a commercially available monoclonal antibody. Kaplan-Meier curves and cox regression analyses were used to assess progression-free survival (PFS) and overall survival (OS). RESULTS: All tumor tissues were immunoreactive for either one or both neuroendocrine biomarkers (chromogranin A and synaptophysin) and Ki67 index was >20% in all cases. p53 immunoreactivity was only shown in 39% of the cases and was not found to be a prognostic marker for the whole cohort. However, p53 immunoreactivity was correlated with shorter PFS in patients with colorectal tumors (HR = 2.1, p = 0.03) in a univariate analysis as well as to poorer PFS (HR = 2.6, p = 0.03) and OS (HR = 3.4, p = 0.02) in patients with colorectal tumors with distant metastases, a correlation which remained significant in the multivariate analyses. CONCLUSION: In this cohort of GEP-NEC patients, p53 expression could not be correlated with clinical outcome. However, in patients with colorectal NECs, p53 expression was correlated with shorter PFS and OS. Further studies are needed to establish the role of immunoreactive p53 as a prognostic marker for GEP-NEC patients.

10 Article Results after surgical treatment of liver metastases in patients with high-grade gastroenteropancreatic neuroendocrine carcinomas. 2017

Galleberg, R B / Knigge, U / Tiensuu Janson, E / Vestermark, L W / Haugvik, S-P / Ladekarl, M / Langer, S W / Grønbæk, H / Österlund, P / Hjortland, G O / Assmus, J / Tang, L / Perren, A / Sorbye, H. ·Department of Oncology, Haukeland University Hospital, Bergen, Norway. Electronic address: renate.berget.galleberg@helse-bergen.no. · Departments of Surgery C and Endocrinology PE, Rigshospitalet, University of Copenhagen, Denmark. Electronic address: rxs484@ku.dk. · Department of Medical Sciences, Uppsala University, Sweden. Electronic address: eva.tiensuu_janson@medsci.uu.se. · Department of Oncology, Odense University Hospital, Denmark. Electronic address: lene.vestermark@syd.dk. · Department of Hepato-Pancreato-Biliary Surgery, Rikshospitalet, Oslo University Hospital, Norway. Electronic address: sphaugvik@yahoo.de. · Department of Oncology, Aarhus University Hospital, Denmark. Electronic address: mortlade@rm.dk. · Department of Oncology, Rigshospitalet, University of Copenhagen, Denmark. Electronic address: swlanger@dadlnet.dk. · Department of Hepatology and Gastroenterology, Aarhus University Hospital, Denmark. Electronic address: henning.gronbaek@aarhus.rm.dk. · Department of Oncology, Helsinki University Central Hospital, Finland. Electronic address: pia.osterlund@pshp.fi. · Department of Oncology, Oslo University Hospital, Norway. Electronic address: goo@ous-hf.no. · Center for Clinical Research, Haukeland University Hospital, Bergen, Norway. Electronic address: jorg.assmus@helse-bergen.no. · Department of Pathology, MSKCC, New York, USA. Electronic address: tangl@MSKCC.ORG. · Department of Pathology, University of Bern, Switzerland. Electronic address: aurel.perren@pathology.unibe.ch. · Department of Oncology, Haukeland University Hospital, Bergen, Norway; Department of Clinical Science, University of Bergen, Norway. Electronic address: Halfdan.sorbye@helse-bergen.no. ·Eur J Surg Oncol · Pubmed #28522174.

ABSTRACT: BACKGROUND: Gastroenteropancreatic neuroendocrine carcinomas (GEP-NEC) are generally characterized by synchronous metastases, high aggressiveness and a dismal prognosis. Current international guidelines do not recommend surgical treatment of liver metastases, however the existing data are scarce. The aim of this study was to evaluate the results of curatively intended resection/radiofrequency ablation (RFA) of liver metastases in patients with metastatic GEP-NEC. METHODS: 32 patients with a diagnosis of high-grade gastroenteropancreatic neuroendocrine neoplasm (Ki-67 > 20%) and with intended curative resection/RFA of liver metastases, were identified among 840 patients from two Nordic GEP-NEC registries. Tumor morphology (well vs poor differentiation) was reassessed. Overall survival (OS) and progression-free survival (PFS) was assessed by Kaplan-Meier analyses for the entire cohort and for subgroups. RESULTS: Median OS after resection/RFA of liver metastases was 35.9 months (95%-CI: 20.6-51.3) with a five-year OS of 43%. The median PFS was 8.4 months (95%-CI: 3.9-13). Four patients (13%) were disease-free after 5 years. Two patients had well-differentiated morphology (NET G3) and 20 patients (63%) had Ki-67 ≥ 55%. A Ki-67 < 55% and receiving adjuvant chemotherapy were statistically significant factors of improved OS after liver resection/RFA. CONCLUSION: This study shows a long median and long term survival after liver surgery/RFA for these selected metastatic GEP-NEC patients, particularly for the group with a Ki-67 in the relatively lower G3 range. Our findings indicate a possible role for surgical treatment of liver metastases in the management of this patient population.

11 Article The uncovering and characterization of a CCKoma syndrome in enteropancreatic neuroendocrine tumor patients. 2016

Rehfeld, Jens F / Federspiel, Birgitte / Agersnap, Mikkel / Knigge, Ulrich / Bardram, Linda. ·a Department of Clinical Biochemistry, Rigshospitalet , University of Copenhagen , Copenhagen , Denmark ; · b Department of Pathology, Rigshospitalet , University of Copenhagen , Copenhagen , Denmark ; · c Department of Surgical Gastroenterology, Rigshospitalet , University of Copenhagen , Copenhagen , Denmark ; · d Department of Medical Endocrinology, Rigshospitalet , University of Copenhagen , Copenhagen , Denmark. ·Scand J Gastroenterol · Pubmed #27191542.

ABSTRACT: OBJECTIVE: Neuroendocrine tumors in the pancreas and the gastrointestinal tract may secrete hormones which cause specific syndromes. Well-known examples are gastrinomas, glucagonomas, and insulinomas. Cholecystokinin-producing tumors (CCKomas) have been induced experimentally in rats, but a CCKoma syndrome in man has remained unknown until now. MATERIAL AND METHODS: Using a panel of immunoassays for CCK peptides and proCCK as well as for chromogranin A, we have examined plasma samples from 284 fasting patients with gastroenteropancreatic neuroendocrine tumors. In hyperCCKemic samples, plasma CCK was further characterized by chromatography. RESULTS: One of the patients displayed gross hyperCCKemia. She was a 58-year old woman with a pancreatic endocrine tumor, liver metastases, 500-1000-fold elevated basal CCK concentration in plasma, diarrhea, severe weight loss, recurrent peptic ulcer and bilestone attacks from a contracted gallbladder. The CCK concentrations in plasma were not affected by resection of the pancreatic tumor, but decreased to normal after hemihepatectomy with removal of the metastases. CONCLUSION: A CCKoma syndrome with severe hypersecretion of CCK exists in man. The duodenal ulcer disease and diarrhea with permanently low gastrin in plasma suggest that CCKomas may mimic gastrinoma-like symptoms, because CCK peptides are full agonists of the gastrin/CCK-B receptor.

12 Article Somatostatin-Immunoreactive Pancreaticoduodenal Neuroendocrine Neoplasms: Twenty-Three Cases Evaluated according to the WHO 2010 Classification. 2016

Luna, Iben Engelund / Monrad, Nina / Binderup, Tina / Boisen Thoegersen, Christina / Hilsted, Linda / Jensen, Claus / Federspiel, Birgitte / Knigge, Ulrich. · ·Neuroendocrinology · Pubmed #26505735.

ABSTRACT: BACKGROUND/OBJECTIVE: Neuroendocrine neoplasms of the pancreas and duodenum with predominant or exclusive immunoreactivity for somatostatin (pdSOMs) are rare, and knowledge about tumour biology, treatment, survival and prognostic factors is limited. This study aims to describe clinical, pathological and biochemical features as well as treatment and prognosis of pdSOMs. DESIGN: Twenty-three patients with pdSOM (9 duodenal, 12 pancreatic and 2 unknown primary tumours) were identified from our prospective neuroendocrine tumour database, and data according to the study aims were recorded. RESULTS: Among the 9 patients with duodenal SOM, the male/female ratio was 4/5. All males and 1 female had neurofibromatosis type 1. Seven patients had stage 1A/B and 2 had stage 2B disease. The Ki-67 index was 1-5% (median 2%). Plasma somatostatin was elevated in the patients with 2B disease. Of the 14 patients with pancreatic SOM or an unknown primary tumour, the male/female ratio was 2/12. One male had multiple endocrine neoplasia type 1. Five had stage 1A/2B and 9 had stage 4. The Ki-67 index was 1-40% (median 7%). Plasma somatostatin was elevated in 7 patients. Patients reported symptoms related to the somatostatinoma syndrome, but none fulfilled the criteria for a full syndrome. Primary tumour in the pancreas, metastatic disease at diagnosis and higher tumour grade were all associated with significantly poorer survival. CONCLUSION: None of the patients with pdSOM presented with the full somatostatinoma syndrome. Prognostic factors are localisation of the primary tumour, dissemination and tumour grade. A Ki-67 index of 5% may discriminate the course of the disease.

13 Article Temozolomide as second or third line treatment of patients with neuroendocrine carcinomas. 2012

Olsen, Ingrid H / Sørensen, Jens B / Federspiel, Birgitte / Kjaer, Andreas / Hansen, Carsten P / Knigge, Ulrich / Langer, Seppo W. ·Department of Oncology, Rigshospitalet, University of Copenhagen, 2100 Copenhagen, Denmark. ingridho@sund.ku.dk ·ScientificWorldJournal · Pubmed #22973169.

ABSTRACT: BACKGROUND: Knowledge of the clinical efficacy in recurrent neuroendocrine carcinomas is sparse. Treatment with temozolomide alone or in combination with capecitabine and bevacizumab has recently shown promising results. PATIENTS AND METHODS: Analysis of consecutive patients with neuroendocrine carcinomas (Ki-67 proliferation index >20%) and performance status 0-2 treated with temozolomide 200 mg/sqm orally days 1-5 every 28 days after at least one previous platin-containing chemotherapy regimen. RESULTS: Twenty-eight eligible patients received a median of 3 courses. Sixteen patients were evaluable for response: Six achieved stable disease and ten progressed. The median survival for the 28 patients was 3.5 months. Survival in patients with tumors of pancreatic origin (n = 7) was 7.0 months versus 2.9 months in non-pancreatic origin (n = 21). Patients in PS 0-1 (n = 22) had a median survival of 4.5 months versus 1.1 months in patients in PS 2 (n = 6). Ki-67 index ≥ 50% was associated with a significantly shorter median survival than Ki-67 index <50% (2.7 months versus 10.9 months). The treatment was well tolerated. CONCLUSION: Temozolomide monotherapy has limited effect in treatment of recurrent neuroendocrine carcinomas. Second line treatment with temozolomide in combination with other compounds should be further investigated in patients in good performance with Ki-67 index <50%.

14 Article [Localization diagnostics of neuroendocrine gastrointestinal tumours]. 2010

Kjaer, Andreas / Knigge, Ulrich / Mortensen, Jann / Hansen, Carsten Palnaes / Fallentin, Eva. ·Klinik for Klinisk Fysiologi, Nuklearmedicin & PET, Rigshospitalet, 2100 København Ø, Denmark. kjaer@mfi.ku.dk ·Ugeskr Laeger · Pubmed #21040674.

ABSTRACT: Localization diagnostics of neuroendocrine tumours is relevant in relation to staging and planning of therapy, including surgery. Imaging modalities are also relevant in relation to biopsy guidance. Currently, the most frequently used methods are somatostatin receptor scintigraphy, computed tomography with contrast and endoscopic ultrasound. The strengths of the different modalities are discussed and it is concluded that frequently a combination of imaging modalities is necessary in the work-up of patients with neuroendocrine tumours.

15 Article [Incidence, pathology and clinical course and symptoms of neuroendocrine gastrointestinal tumours]. 2010

Federspiel, Birgitte Hartnack / Hansen, Carsten Palnaes / Vainer, Ben / Hasselby, Jane Preuss / Bardram, Linda / Knigge, Ulrich. ·Patologiafdelingen, Rigshospitalet, 2100 København Ø, Denmark. birgitte.federspiel@rh.regionh.dk ·Ugeskr Laeger · Pubmed #21040672.

ABSTRACT: Gastro-entero-pancreatic neuroendocrine tumours (GEP NETs) are unusual. Their incidence, the different tumour types and growth patterns are described. The tumours should be classified according to the WHO 2000 classification and the Tumour Node Metastasis classification according to guidelines from the European Neuroendocrine Tumour Society. Important parameters are localization, size, hormonal secretion, mitotic index, and proliferation index (Ki-67) of the primary tumour. Patients with GEP NET should be referred to as few centres as possible in order to obtain the highest experience and the greatest understanding of these tumours thereby achieving the capacity to offer patients the best possible treatment and to create optimal conditions for research.

16 Article [Treatment of neuroendocrine tumours of the gastrointestinal tract]. 2010

Hansen, Carsten Palnaes / Langer, Seppo / Frevert, Susanne / Mortensen, Jann / Kjaer, Andreas / Knigge, Ulrich. ·Kirurgisk Klinik C, Rigshospitalet, 2100 København Ø, Denmark. city@oncable.dk ·Ugeskr Laeger · Pubmed #21040671.

ABSTRACT: The prognosis of neuroendocrine tumours of the gastrointestinal tract and pancreas is difficult to estimate due to their heterogeneous nature. Survival without dissemination may reach 90%, while metastases reduce the 5-year survival to less than 50%. Radical surgery offers the only possibility of cure. Palliative therapy includes surgery and intra-arterial embolization of hepatic metastases, chemotherapy, biotherapy with interferon-alpha and radionuclear treatment. Tumour-targeted therapy with tyrosine kinase inhibitors, mammalian target of rapamycin inhibitors or monoclonal antibodies are under investigation in phase-III studies.

17 Article [Biotherapy of neuroendocrine tumours of the gastrointestinal tract and pancreas]. 2008

Hansen, Carsten Palnaes / Knigge, Ulrich. ·Rigshospitalet, Kirurgisk Afdeling C, København Ø. cph@rh.dk ·Ugeskr Laeger · Pubmed #18565299.

ABSTRACT: Biotherapy of hormonal symptoms and tumour growth is a mainstay in the therapy of metastatic neuroendocrine tumours of the gastrointestinal tract and pancreas. Symptomatic relief can be achieved by somatostatin analogues and interferon, either alone or in combination. The effect on tumour growth is less convincing although a stabilization of disease is recorded in almost 50% of patients. Interferon treatment should mainly be considered for tumours with a low proliferation index.

18 Minor [Endoscopic ultrasonography in patients with suspected neuroendocrine tumors]. 2008

Knigge, Ulrich / Hansen, Carsten Palnaes / Gustafsen, Jens / Kjaer, Andreas. · ·Ugeskr Laeger · Pubmed #18763378.

ABSTRACT: -- No abstract --