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Evaluation and follow up of potentially cured patients after R0 or R1 resection of a neuroendocrine tumor

Laufzeit: 01.01.2008 - 31.12.2014

Kurzfassung


Neuroendocrine tumors generally/frequently are perceived as (semi-)malignant tumors with a rather good prognosis (especially the ones with a low proliferation index), and guidelines recommend follow up/watchful waiting in many phases of the disease e.g. in the potentially R0 or in Rx resected tumors and in accidentally found NET after surgical removal, but also in non-symptomatic stable low proliferative NETs. This general perception may lead to “undertreatment” or loss of follow up in a...Neuroendocrine tumors generally/frequently are perceived as (semi-)malignant tumors with a rather good prognosis (especially the ones with a low proliferation index), and guidelines recommend follow up/watchful waiting in many phases of the disease e.g. in the potentially R0 or in Rx resected tumors and in accidentally found NET after surgical removal, but also in non-symptomatic stable low proliferative NETs. This general perception may lead to “undertreatment” or loss of follow up in a considerable number of patients especially when they are not treated/followed up in specialized centres. Furthermore, our own personal extensive experience in the treatment of patients with NETs suggests, that the prognosis of at least some NETs is not as good as it has been anticipated previously, and that a more aggressive approach or even an adjuvant or neoadjuvant treatment might improve the outcome in these patients. However, due to the rareness of the disease and due to the great heterogeneity of NETs, only sparse data is available on the natural course and the prognosis of these rare tumors. In order to address this question, we plan to retrospectively evaluate all patients which have been treated in the university hospital of Mainz due to NETs between the years 1998-2008, and prospectively to the year 2010. Furthermore all patients which have been in a situation of watchful waiting without measurable tumor masses (R0 or Rx resected) or clinical symptoms will be contacted, clinical reevaluated if possible and followed up for evaluation of their outcome (survival, disease free time, time to progression, quality of live, tumor markers etc) for 2 years. This data will be crucial for the evaluation and planning of a potential adjuvant or neoadjuvant therapy pilot study. For this purpose a universally usable Access based NET-database will be designed which could also be made available to other NET-centres as a tool for the registration and therapy planning of NET Patients. This tool could also be very important/helpful in the setting of a potential future multicentre approach to this question. » weiterlesen» einklappen

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