Ron Basuroy

Review article: the investigation and management of rectal neuroendocrine tumours

Gastric carcinoids (GCs) or neuroendocrine tumours (NETs) are increasingly identified at endoscopy, and account for 0.6–2% of all gastric polyps identified. The SEER database in the US has demonstrated a rising incidence of gastric NETs amongst all NETs; from 2.2% between 1950 and 1969 to 6.0% between 2000 and 2007.

A multimodal approach to the management of neuroendocrine tumour liver metastases

Neuroendocrine tumours (NETs) are often indolent malignancies that commonly present with metastatic disease in the liver. Surgical, locoregional, and systemic treatment modalities are reviewed. A multidisciplinary approach to patient care is suggested to ensure all therapeutic options explored.

Presenting Symptoms and Delay in Diagnosis of Gastrointestinal and Pancreatic Neuroendocrine Tumours

The gastrointestinal tract and pancreas are common primary sites for neuroendocrine tumours (NETs). Patients often report a long duration of non-specific symptoms in the year prior to diagnosis. The aims of this study were, firstly, to establish pre-diagnosis patterns of symptoms, and secondly, to determine the time from onset of symptoms to NET diagnosis and understand the interaction with primary and secondary healthcare providers. A survey was designed on a web-based survey platform with the focus on patient symptoms prior to diagnosis and a screen for functional diarrhoea (Rome III criteria [C4]). A total of 303 responses were received. The median duration from the time of first symptoms to diagnosis was 36 months for small bowel NETs and 24 months for pancreatic NETs. Common first symptoms were pain (36%), flushing (24%), and diarrhoea (24%); 29% of small bowel NET respondents were given an initial diagnosis of irritable bowel syndrome. Dyspepsia was the second most common initial incorrect diagnosis. Respondents saw their GP 5 times over a median 18-month period for their symptoms; 31% of patients were diagnosed following unplanned emergency admission. In conclusion, this survey demonstrates a median time to diagnosis of 36 months for patients with small bowel NETs. Incorrect initial diagnosis appears to be very common, with a high number of attendances in primary and secondary care prior to a correct diagnosis being made. An earlier diagnosis may improve patients’ quality of life and possible survival.

Ileocolonic neuroendocrine tumours identified in the English bowel cancer screening programme

Ileocolonic neuroendocrine tumours (NETs) are diagnosed as part of bowel cancer screening programmes (BCSPs). The aim of this study was to identify and characterize NETs diagnosed within the English BCSP, a double‐screen programme that uses guaic faecal occult blood test (gFOBT) screening and colonoscopy, by interrogating the national colorectal screening database and validating the findings with individual BCSP centres.

Letter: the response to somatostatin analogues in neuroendocrine tumours is influenced by Ki67 score – authors' reply

ACKNOWLEDGEMENTS The authors thank all the participants to the ELIOS (Educational Learning Investigational Observational Study) Multicentre Study, for their efforts in acquisition of the data. Declaration of personal interests: Antongiulio Faggiano: Novartis, Ipsen (RF); Salvatore Tafuto: Novartis, Ipsen, Italfarmaco (RF); Ferdinando Riccardi: Novartis, Ipsen (RF); Giovannella Palmieri: Novartis, Ipsen (RF); Silvana Leo: Ipsen (RF); Lucia Franca Tozzi: Ipsen (RF); Annamaria Colao: Novartis, Ipsen (RF; C; BM). The other authors indicated no financial relationship. (E) Employment; (C) Consultancies; (RF) Research funding to the Department; (H) Honoraria; (O) Ownership of stock or shares; (R) Royalties; (P) Patents; (BM) Board membership. Declaration of funding interests: This study was partially supported by an unrestricted grant from Ipsen.