Follow-up Recommendations for Completely Resected Gastroenteropancreatic Neuroendocrine Tumors

Simron Singh, Lesley Moody, David L. Chan, David C. Metz, Jonathan Strosberg, Timothy Asmis, Dale L. Bailey, Emily Bergsland, Kari Brendtro, Richard Carroll, Sean Cleary, Michelle Kim, Grace Kong, Calvin Law, Ben Lawrence, Alexander McEwan, Caitlin McGregor, Michael Michael, Janice Pasieka, Nick PavlakisRodney Pommier, Michael Soulen, David Wyld, Eva Segelov

Research output: Contribution to journalArticlepeer-review

56 Scopus citations


There is no consensus on optimal follow-up for completely resected gastroenteropancreatic neuroendocrine tumors. Published guidelines for follow-up are complex and emphasize closer surveillance in the first 3 years after resection. Neuroendocrine tumors have a different pattern and timescale of recurrence, and thus require more practical and tailored follow-up. The Commonwealth Neuroendocrine Tumour Collaboration convened an international multidisciplinary expert panel, in collaboration with the North American Neuroendocrine Tumor Society, to create patient-centered follow-up recommendations for completely resected gastroenteropancreatic neuroendocrine tumors. This panel used the RAND/UCLA (University of California, Los Angeles) Appropriateness Method to generate recommendations. A large international survey was conducted outlining current the surveillance practice of neuroendocrine tumor practitioners and shortcomings of the current guidelines. A systematic review of available data to date was supplemented by recurrence data from 2 large patient series. The resultant guidelines suggest follow-up for at least 10 years for fully resected small-bowel and pancreatic neuroendocrine tumors and also identify clinical situations in which no follow-up is required. These recommendations stratify follow-up strategies based on evidence-based prognostic factors that allow for a more individualized patient-centered approach to this complex and heterogeneous malignant neoplasm.

Original languageEnglish (US)
Pages (from-to)1597-1604
Number of pages8
JournalJAMA Oncology
Issue number11
StatePublished - Nov 2018

ASJC Scopus subject areas

  • Oncology
  • Cancer Research


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