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Julie Refardt ENETS Center of Excellence, Department of Internal Medicine, Section of Endocrinology, Erasmus Medical Center, Rotterdam, The Netherlands
ENETS Center of Excellence, Department of Endocrinology, University Hospital Basel, Basel, Switzerland
Department of Clinical Research, University of Basel, Basel, Switzerland

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Wouter T Zandee ENETS Center of Excellence, Department of Internal Medicine, Section of Endocrinology, Erasmus Medical Center, Rotterdam, The Netherlands

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Tessa Brabander ENETS Center of Excellence, Department of Radiology & Nuclear Medicine, Erasmus Medical Center, Rotterdam, The Netherlands

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Richard A Feelders ENETS Center of Excellence, Department of Internal Medicine, Section of Endocrinology, Erasmus Medical Center, Rotterdam, The Netherlands

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Gaston J H Franssen Department of Surgery, Section of Surgical Oncology, Erasmus Medical Center, Rotterdam, The Netherlands

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Leo J Hofland ENETS Center of Excellence, Department of Internal Medicine, Section of Endocrinology, Erasmus Medical Center, Rotterdam, The Netherlands

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Emanuel Christ ENETS Center of Excellence, Department of Endocrinology, University Hospital Basel, Basel, Switzerland
Department of Clinical Research, University of Basel, Basel, Switzerland

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Wouter W de Herder ENETS Center of Excellence, Department of Internal Medicine, Section of Endocrinology, Erasmus Medical Center, Rotterdam, The Netherlands

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Johannes Hofland ENETS Center of Excellence, Department of Internal Medicine, Section of Endocrinology, Erasmus Medical Center, Rotterdam, The Netherlands

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surface, with the somatostatin receptor subtype 2 (SST2) being expressed in up to 90% of gastroenteropancreatic NETs ( Reubi et al. 2010 , Gatto & Hofland 2011 ). According to this feature, SSTR-based imaging is the current standard for diagnosing and

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Margaux Foulfoin Hospices Civils de Lyon, Hôpital Edouard Herriot, Service de Gastroentérologie et d’Oncologie Médicale, Lyon, France

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Emmanuelle Graillot Hospices Civils de Lyon, Hôpital Edouard Herriot, Service de Gastroentérologie et d’Oncologie Médicale, Lyon, France
University of Lyon, Université Lyon 1, Lyon, France

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Mustapha Adham University of Lyon, Université Lyon 1, Lyon, France
Hospices Civils de Lyon, Hôpital Edouard Herriot, Service de chirurgie, Lyon, France

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Pascal Rousset University of Lyon, Université Lyon 1, Lyon, France
Hospices Civils de Lyon, Hôpital Edouard Herriot, Service de radiologie, Lyon, France

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Julien Forestier Hospices Civils de Lyon, Hôpital Edouard Herriot, Service de Gastroentérologie et d’Oncologie Médicale, Lyon, France

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Valérie Hervieu University of Lyon, Université Lyon 1, Lyon, France
Hospices Civils de Lyon, Hôpital Edouard Herriot, Service Central d’Anatomie et Cytologie Pathologiques, Lyon, France

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Philip Robinson Hospices Civils de Lyon, DRCI, Lyon, France

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Jean-Yves Scoazec Hospices Civils de Lyon, Hôpital Edouard Herriot, Service Central d’Anatomie et Cytologie Pathologiques, Lyon, France

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Catherine Lombard-Bohas Hospices Civils de Lyon, Hôpital Edouard Herriot, Service de Gastroentérologie et d’Oncologie Médicale, Lyon, France

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Thomas Walter Hospices Civils de Lyon, Hôpital Edouard Herriot, Service de Gastroentérologie et d’Oncologie Médicale, Lyon, France
University of Lyon, Université Lyon 1, Lyon, France

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neuroendocrine tumors . New England Journal of Medicine 371 224 – 233 . ( doi:10.1056/NEJMoa1316158 ) Coriat R Walter T Terris B Couvelard A Ruszniewski P 2016 Gastroenteropancreatic well-differentiated grade 3 neuroendocrine tumors

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Annemiek Walenkamp
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Guillermo Crespo Department of Medical Oncology, Department of Medical Oncology, Department of Endocrine Oncology, Department of Cancer Research and Molecular Medicine, 2nd Department of Medicine, Department of Gastroenterology, Department of General Internal Medicine, Department of Clinical Sciences and Community Health (DISCCO), Laboratory of Endocrine and Metabolic Research, Department of Endocrine Oncology, UCL Cancer Institute, University Medical Centre Groningen, University of Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands

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Felipe Fierro Maya Department of Medical Oncology, Department of Medical Oncology, Department of Endocrine Oncology, Department of Cancer Research and Molecular Medicine, 2nd Department of Medicine, Department of Gastroenterology, Department of General Internal Medicine, Department of Clinical Sciences and Community Health (DISCCO), Laboratory of Endocrine and Metabolic Research, Department of Endocrine Oncology, UCL Cancer Institute, University Medical Centre Groningen, University of Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands

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Reidar Fossmark Department of Medical Oncology, Department of Medical Oncology, Department of Endocrine Oncology, Department of Cancer Research and Molecular Medicine, 2nd Department of Medicine, Department of Gastroenterology, Department of General Internal Medicine, Department of Clinical Sciences and Community Health (DISCCO), Laboratory of Endocrine and Metabolic Research, Department of Endocrine Oncology, UCL Cancer Institute, University Medical Centre Groningen, University of Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands

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Peter Igaz Department of Medical Oncology, Department of Medical Oncology, Department of Endocrine Oncology, Department of Cancer Research and Molecular Medicine, 2nd Department of Medicine, Department of Gastroenterology, Department of General Internal Medicine, Department of Clinical Sciences and Community Health (DISCCO), Laboratory of Endocrine and Metabolic Research, Department of Endocrine Oncology, UCL Cancer Institute, University Medical Centre Groningen, University of Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands

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Anja Rinke Department of Medical Oncology, Department of Medical Oncology, Department of Endocrine Oncology, Department of Cancer Research and Molecular Medicine, 2nd Department of Medicine, Department of Gastroenterology, Department of General Internal Medicine, Department of Clinical Sciences and Community Health (DISCCO), Laboratory of Endocrine and Metabolic Research, Department of Endocrine Oncology, UCL Cancer Institute, University Medical Centre Groningen, University of Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands

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Gianluca Tamagno Department of Medical Oncology, Department of Medical Oncology, Department of Endocrine Oncology, Department of Cancer Research and Molecular Medicine, 2nd Department of Medicine, Department of Gastroenterology, Department of General Internal Medicine, Department of Clinical Sciences and Community Health (DISCCO), Laboratory of Endocrine and Metabolic Research, Department of Endocrine Oncology, UCL Cancer Institute, University Medical Centre Groningen, University of Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands

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Giovanni Vitale Department of Medical Oncology, Department of Medical Oncology, Department of Endocrine Oncology, Department of Cancer Research and Molecular Medicine, 2nd Department of Medicine, Department of Gastroenterology, Department of General Internal Medicine, Department of Clinical Sciences and Community Health (DISCCO), Laboratory of Endocrine and Metabolic Research, Department of Endocrine Oncology, UCL Cancer Institute, University Medical Centre Groningen, University of Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands
Department of Medical Oncology, Department of Medical Oncology, Department of Endocrine Oncology, Department of Cancer Research and Molecular Medicine, 2nd Department of Medicine, Department of Gastroenterology, Department of General Internal Medicine, Department of Clinical Sciences and Community Health (DISCCO), Laboratory of Endocrine and Metabolic Research, Department of Endocrine Oncology, UCL Cancer Institute, University Medical Centre Groningen, University of Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands

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Kjell Öberg Department of Medical Oncology, Department of Medical Oncology, Department of Endocrine Oncology, Department of Cancer Research and Molecular Medicine, 2nd Department of Medicine, Department of Gastroenterology, Department of General Internal Medicine, Department of Clinical Sciences and Community Health (DISCCO), Laboratory of Endocrine and Metabolic Research, Department of Endocrine Oncology, UCL Cancer Institute, University Medical Centre Groningen, University of Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands

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Tim Meyer Department of Medical Oncology, Department of Medical Oncology, Department of Endocrine Oncology, Department of Cancer Research and Molecular Medicine, 2nd Department of Medicine, Department of Gastroenterology, Department of General Internal Medicine, Department of Clinical Sciences and Community Health (DISCCO), Laboratory of Endocrine and Metabolic Research, Department of Endocrine Oncology, UCL Cancer Institute, University Medical Centre Groningen, University of Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands

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in metastatic gastroenteropancreatic neuroendocrine tumours . British Journal of Cancer 109 1414 – 1419 . ( doi:10.1038/bjc.2013.470 ). Ameri P Ferone D 2012 Diffuse endocrine system, neuroendocrine tumors and immunity: what's new

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Louis de Mestier Université de Paris, Department of Gastroenterology-Pancreatology, Beaujon University Hospital (APHP), Clichy, France

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Angela Lamarca Division of Cancer Sciences, Department of Medical Oncology, The Christie NHS Foundation, University of Manchester, Manchester, United Kingdom

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Jorge Hernando Department of Medical Oncology, Vall d’Hebron University Hospital and Vall d´Hebron Institute of Oncology (VHIO), Barcelona, Spain

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Wouter Zandee Department of Internal Medicine, Sector Endocrinology, Erasmus University Medical Center and Erasmus MC Cancer Institute, Rotterdam, The Netherlands
Division of Endocrinology, Department of Internal Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands

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Teresa Alonso-Gordoa Department of Medical Oncology, Ramon y Cajal University Hospital, IRYCIS, Madrid, Spain

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Marine Perrier Department of Hepato-Gastroenterology and Digestive Oncology, Robert-Debré University Hospital, Reims, France

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Annemiek ME Walenkamp Department of Medical Oncology, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands

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Bipasha Chakrabarty Department of Pathology, The Christie, Manchester, United Kingdom

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Stefania Landolfi Department of Pathology, Vall d’Hebron University Hospital, Barcelona, Spain

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Marie-Louise F Van Velthuysen Department of Pathology, Erasmus University Medical Center and Erasmus MC Cancer Institute, Rotterdam, The Netherlands

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Gursah Kats-Ugurlu Department of Pathology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands

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Alejandra Caminoa Department of Pathology, University Hospital Ramon y Cajal, Madrid, Spain

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Maxime Ronot Université de Paris, Department of Radiology, Beaujon University Hospital (APHP), Clichy, France

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Prakash Manoharan Department of Radiology and Nuclear Medicine, The Christie, Manchester, United Kingdom

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Alejandro Garcia-Alvarez Department of Medical Oncology, Vall d’Hebron University Hospital and Vall d´Hebron Institute of Oncology (VHIO), Barcelona, Spain

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Tessa Brabander Department of Radiology and Nuclear Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands

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María Isabel García Gómez-Muriel Department of Radiology, University Hospital Ramon y Cajal, Madrid, Spain

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Guillaume Cadiot Department of Hepato-Gastroenterology and Digestive Oncology, Robert-Debré University Hospital, Reims, France

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Anne Couvelard Université de Paris, Department of Pathology, Beaujon/Bichat University Hospital (APHP), Clichy/Paris, France

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Jaume Capdevila Department of Medical Oncology, Vall d’Hebron University Hospital and Vall d´Hebron Institute of Oncology (VHIO), Barcelona, Spain

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Marianne E Pavel Department of Endocrinology, Erlangen University Hospital, Erlangen, Germany

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Jérôme Cros Université de Paris, Department of Pathology, Beaujon/Bichat University Hospital (APHP), Clichy/Paris, France

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Peptide receptor radionuclide therapy in gastroenteropancreatic NEN G3: a multicenter cohort study . Endocrine-Related Cancer 26 227 – 239 . ( https://doi.org/10.1530/ERC-18-0424 ) Cives M Ghayouri M Morse B Brelsford M Black M Rizzo A

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L D de Hosson Department of Medical Oncology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands

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J Stelwagen Department of Medical Oncology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands

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G Bouma Department of Medical Oncology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands

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B Sijtema Dieticians, Department of Medical Oncology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands

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S Huitema Dieticians, Department of Medical Oncology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands

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H J R van Faassen Department of Laboratory Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands

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G H de Bock Department of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands

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D J A de Groot Department of Medical Oncology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands

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M J E Campmans-Kuijpers Department of Gastroenterology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands

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I P Kema Department of Laboratory Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands

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E G E de Vries Department of Medical Oncology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands

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A M E Walenkamp Department of Medical Oncology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands

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in 138 gastroenteropancreatic NET patients ( Massironi et al . 2017 ). NET patients experience a lower quality of life (QoL) as compared with the general population, among others, due to increased bowel movements ( Pearman et al . 2016

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Anna Koumarianou Medical Oncology Unit, Endocrine Unit, MRI Unit, Pathology Department, Fourth Department of Surgery, Medical Oncology Unit, Second Department of Internal Medicine Propaedeutic, Attikon University General Hospital, Rimini 1, 12462 Athens, Greece

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Stavroula Antoniou Medical Oncology Unit, Endocrine Unit, MRI Unit, Pathology Department, Fourth Department of Surgery, Medical Oncology Unit, Second Department of Internal Medicine Propaedeutic, Attikon University General Hospital, Rimini 1, 12462 Athens, Greece

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George Kanakis Medical Oncology Unit, Endocrine Unit, MRI Unit, Pathology Department, Fourth Department of Surgery, Medical Oncology Unit, Second Department of Internal Medicine Propaedeutic, Attikon University General Hospital, Rimini 1, 12462 Athens, Greece

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Nikolaos Economopoulos Medical Oncology Unit, Endocrine Unit, MRI Unit, Pathology Department, Fourth Department of Surgery, Medical Oncology Unit, Second Department of Internal Medicine Propaedeutic, Attikon University General Hospital, Rimini 1, 12462 Athens, Greece

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Dimitra Rontogianni Medical Oncology Unit, Endocrine Unit, MRI Unit, Pathology Department, Fourth Department of Surgery, Medical Oncology Unit, Second Department of Internal Medicine Propaedeutic, Attikon University General Hospital, Rimini 1, 12462 Athens, Greece

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Anastasios Ntavatzikos Medical Oncology Unit, Endocrine Unit, MRI Unit, Pathology Department, Fourth Department of Surgery, Medical Oncology Unit, Second Department of Internal Medicine Propaedeutic, Attikon University General Hospital, Rimini 1, 12462 Athens, Greece

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Nikolaos Tsavaris Medical Oncology Unit, Endocrine Unit, MRI Unit, Pathology Department, Fourth Department of Surgery, Medical Oncology Unit, Second Department of Internal Medicine Propaedeutic, Attikon University General Hospital, Rimini 1, 12462 Athens, Greece

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Dimitrios Pectasides Medical Oncology Unit, Endocrine Unit, MRI Unit, Pathology Department, Fourth Department of Surgery, Medical Oncology Unit, Second Department of Internal Medicine Propaedeutic, Attikon University General Hospital, Rimini 1, 12462 Athens, Greece

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George Dimitriadis Medical Oncology Unit, Endocrine Unit, MRI Unit, Pathology Department, Fourth Department of Surgery, Medical Oncology Unit, Second Department of Internal Medicine Propaedeutic, Attikon University General Hospital, Rimini 1, 12462 Athens, Greece

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Gregory Kaltsas Medical Oncology Unit, Endocrine Unit, MRI Unit, Pathology Department, Fourth Department of Surgery, Medical Oncology Unit, Second Department of Internal Medicine Propaedeutic, Attikon University General Hospital, Rimini 1, 12462 Athens, Greece

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Downstaging of gastroenteropancreatic tumours (arrows) after TeBeSa combination therapy. MRI details shown before treatment (a) and (c) and after six cycles (b) and (d) for two patients with a pancreatic (a)/(b) and a duodenal tumour (c)/(d). During the past 4

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Sarah B Bateni Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
University of Alabama at Birmingham, Department of Surgery, Division of Surgical Oncology, Birmingham, Alabama, USA

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Natalie G Coburn Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
Susan Leslie Clinic for Neuroendocrine Tumors, Odette Cancer Centre - Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
Clinical evaluative sciences, Sunnybrook Research Institute, Toronto, Ontario, Canada

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Calvin Law Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
Susan Leslie Clinic for Neuroendocrine Tumors, Odette Cancer Centre - Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada

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Simron Singh Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
Susan Leslie Clinic for Neuroendocrine Tumors, Odette Cancer Centre - Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
Clinical evaluative sciences, Sunnybrook Research Institute, Toronto, Ontario, Canada

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Sten Myrehaug Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
Susan Leslie Clinic for Neuroendocrine Tumors, Odette Cancer Centre - Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
Clinical evaluative sciences, Sunnybrook Research Institute, Toronto, Ontario, Canada

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Angela Assal Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
Susan Leslie Clinic for Neuroendocrine Tumors, Odette Cancer Centre - Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
Clinical evaluative sciences, Sunnybrook Research Institute, Toronto, Ontario, Canada

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Julie Hallet Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
Susan Leslie Clinic for Neuroendocrine Tumors, Odette Cancer Centre - Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
Clinical evaluative sciences, Sunnybrook Research Institute, Toronto, Ontario, Canada

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.4160 ) Massironi S Campana D Pusceddu S Albertelli M Faggiano A Panzuto F Smiroldo V Andreasi V Rossi RE Maggio I , 2020 Second primary neoplasms in patients with lung and gastroenteropancreatic neuroendocrine neoplasms: data from a

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M Cives Department of Gastrointestinal Oncology, Department of Medicine, H. Lee Moffitt Cancer Center and Research Institute, 12902 Magnolia Drive, Tampa, Florida 33612, USA

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P L Kunz Department of Gastrointestinal Oncology, Department of Medicine, H. Lee Moffitt Cancer Center and Research Institute, 12902 Magnolia Drive, Tampa, Florida 33612, USA

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B Morse Department of Gastrointestinal Oncology, Department of Medicine, H. Lee Moffitt Cancer Center and Research Institute, 12902 Magnolia Drive, Tampa, Florida 33612, USA

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D Coppola
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M J Schell Department of Gastrointestinal Oncology, Department of Medicine, H. Lee Moffitt Cancer Center and Research Institute, 12902 Magnolia Drive, Tampa, Florida 33612, USA

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T Campos Department of Gastrointestinal Oncology, Department of Medicine, H. Lee Moffitt Cancer Center and Research Institute, 12902 Magnolia Drive, Tampa, Florida 33612, USA

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P T Nguyen Department of Gastrointestinal Oncology, Department of Medicine, H. Lee Moffitt Cancer Center and Research Institute, 12902 Magnolia Drive, Tampa, Florida 33612, USA

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P Nandoskar Department of Gastrointestinal Oncology, Department of Medicine, H. Lee Moffitt Cancer Center and Research Institute, 12902 Magnolia Drive, Tampa, Florida 33612, USA

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V Khandelwal Department of Gastrointestinal Oncology, Department of Medicine, H. Lee Moffitt Cancer Center and Research Institute, 12902 Magnolia Drive, Tampa, Florida 33612, USA

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J R Strosberg Department of Gastrointestinal Oncology, Department of Medicine, H. Lee Moffitt Cancer Center and Research Institute, 12902 Magnolia Drive, Tampa, Florida 33612, USA

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improvement in time-to-progression, thus defining a new paradigm in the treatment of small-intestinal NETs ( Rinke et al . 2009 ). More recently, the CLARINET trial randomized patients with hormonally nonfunctioning gastroenteropancreatic NETs to receive

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Cecilia Piani
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Giulia M Franchi
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Chiara Cappelletti
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Marina Scavini
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Luca Albarello General Medicine, Pathology Unit, Pancreatic Unit, Gastroenterology and Endoscopic Unit, Diabetes and Endocrinology Unit, San Raffaele Scientific Institute, Università Vita-Salute San Raffaele, Via Olgettina 60, 20132 Milano, Italy

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Alessandro Zerbi General Medicine, Pathology Unit, Pancreatic Unit, Gastroenterology and Endoscopic Unit, Diabetes and Endocrinology Unit, San Raffaele Scientific Institute, Università Vita-Salute San Raffaele, Via Olgettina 60, 20132 Milano, Italy

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Paolo Giorgio Arcidiacono General Medicine, Pathology Unit, Pancreatic Unit, Gastroenterology and Endoscopic Unit, Diabetes and Endocrinology Unit, San Raffaele Scientific Institute, Università Vita-Salute San Raffaele, Via Olgettina 60, 20132 Milano, Italy

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Emanuele Bosi
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Marco F Manzoni
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the last few decades may be accounted for by increased awareness, improved diagnostic tools and a revision in the definition. The main primary sites of NETs are the gastro–entero–pancreatic (GEP) tract (62–67%) and the lung (22–27%; Taal & Visser 2004

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Paula Fontes Asprino Hospital Sírio-Libanês (HSL), São Paulo, São Paulo, Brazil

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Rudinei Diogo Marques Linck Hospital Sírio-Libanês (HSL), São Paulo, São Paulo, Brazil
Instituto do Câncer do Estado de São Paulo (ICESP), São Paulo, São Paulo, Brazil

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Jônatas Cesar Instituto de Biociências – Universidade de São Paulo (IB-USP), São Paulo, São Paulo, Brazil

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Florêncio Porto Freitas Hospital Sírio-Libanês (HSL), São Paulo, São Paulo, Brazil

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Fernanda Christtanini Koyama Hospital Sírio-Libanês (HSL), São Paulo, São Paulo, Brazil

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Rachel Simões Pimenta Riechelmann Instituto do Câncer do Estado de São Paulo (ICESP), São Paulo, São Paulo, Brazil

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Frederico Perego Costa Hospital Sírio-Libanês (HSL), São Paulo, São Paulo, Brazil

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Paulo Marcelo Gehm Hoff Hospital Sírio-Libanês (HSL), São Paulo, São Paulo, Brazil
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Pedro Alexandre Favoretto Galante Hospital Sírio-Libanês (HSL), São Paulo, São Paulo, Brazil

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Jorge Sabbaga Hospital Sírio-Libanês (HSL), São Paulo, São Paulo, Brazil
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, epidemiological studies have demonstrated that non-syndromic individuals with an affected relative are at an increased risk of developing gastroenteropancreatic (GEP) NENs. In individuals with affected siblings, the relative risk of GEP NEN increases by 13.4-fold

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