Magi Ludovica, Mazzuca Federica, Rinzivillo Maria, Arrivi Giulia, Pilozzi Emanuela, Prosperi Daniela, Iannicelli Elsa, Mercantini Paolo, Rossi Michele, Pizzichini Patrizia, Laghi Andrea, Signore Alberto, Marchetti Paolo, Annibale Bruno, Panzuto Francesco
Digestive Disease Unit, ENETS Center of Excellence, Sant'Andrea University Hospital, 00189 Rome, Italy.
Medical Oncology Unit, ENETS Center of Excellence, Sant'Andrea University Hospital, 00189 Rome, Italy.
J Clin Med. 2019 Jun 25;8(6):910. doi: 10.3390/jcm8060910.
Multidisciplinary approach is widely advised for an effective care of patients with neuroendocrine neoplasia (NEN). Since data on efficacy of multidisciplinary management of NENs patients in referral centers are scanty, this study aimed at analyzing the modality of presentation and clinical outcome of patients with NENs managed by a dedicated multidisciplinary team.
In this prospective observational study, we included all consecutive new patients visiting the Sant'Andrea Hospital in Rome (ENETS-Center of Excellence) between January 2014 and June 2018.
A total of 195 patients were evaluated. The most frequent sites were pancreas (38.5%), small bowel (22%), and lung (9.7%). Median Ki67 was 3%. After the first visit at the center, additional radiological and/or nuclear medicine procedures were requested in 163 patients (83.6%), whereas histological data revision was advised in 84 patients (43.1%) (revision of histological slides: 27.7%, new bioptic sampling: 15.4%). After that, disease imaging staging and grading was modified in 30.7% and 17.9% of patients, respectively. Overall, a change in therapeutic management was proposed in 98 patients (50.3%).
Multidisciplinary approach in a dedicated team may lead to change of disease imaging staging and grading in a significant proportion of patients. Enhancing referral routes to dedicated-NEN center should be promoted, since it may improve patients' clinical outcome.
广泛建议采用多学科方法来有效护理神经内分泌肿瘤（NEN）患者。由于关于转诊中心NEN患者多学科管理疗效的数据较少，本研究旨在分析由专门的多学科团队管理的NEN患者的就诊方式和临床结局。
在这项前瞻性观察性研究中，我们纳入了2014年1月至2018年6月期间连续就诊于罗马圣安德烈亚医院（ENETS卓越中心）的所有新患者。
共评估了195例患者。最常见的部位是胰腺（38.5%）、小肠（22%）和肺（9.7%）。Ki67中位数为3%。在该中心首次就诊后，163例患者（83.6%）被要求进行额外的放射学和/或核医学检查，而84例患者（43.1%）被建议进行组织学数据复查（组织学切片复查：27.7%，新的活检采样：15.4%）。此后，分别有30.7%和17.9%的患者疾病影像分期和分级发生了改变。总体而言，98例患者（50.3%）的治疗管理方案被提出改变。
专门团队采用的多学科方法可能会使相当一部分患者的疾病影像分期和分级发生改变。应促进加强向专门的NEN中心的转诊途径，因为这可能会改善患者的临床结局。
