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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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Introduction The classification of neuroendocrine neoplasms (NENs) relies on differentiation (well-differentiated neuroendocrine tumors (NETs) or poorly-differentiated neuroendocrine carcinomas (NECs)) and the proliferation index, which is

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Lena Weindl Department of Medicine 1, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany

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Imke Atreya Department of Medicine 1, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany

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Peter Dietrich Department of Medicine 1, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
Institute of Biochemistry, Emil-Fischer-Zentrum, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany

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Sabine Neubeck Department of Medicine 1, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany

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Markus F Neurath Department of Medicine 1, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
Deutsches Zentrum Immuntherapie DZI, Erlangen, Germany
Comprehensive Cancer Center CCC-EMN, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany

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Marianne Pavel Department of Medicine 1, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
Deutsches Zentrum Immuntherapie DZI, Erlangen, Germany
Comprehensive Cancer Center CCC-EMN, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany

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of the latest evidence, further separation of high-grade NENs into well differentiated neuroendocrine tumors (NETs G3) and poorly differentiated neuroendocrine carcinomas (NECs G3) is emerging due to prognostic relevance ( Sorbye et al. 2013

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Martin B Niederle
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Monika Hackl Division of General Surgery, Bundesanstalt ‘Statistik Österreich’ (Austria Statistics), Department of Clinical Pathology, Section of Endocrine Surgery, Department of Surgery, Medical University of Vienna, Währinger Gürtel 18–20, A-1090 Vienna, Austria

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Klaus Kaserer Division of General Surgery, Bundesanstalt ‘Statistik Österreich’ (Austria Statistics), Department of Clinical Pathology, Section of Endocrine Surgery, Department of Surgery, Medical University of Vienna, Währinger Gürtel 18–20, A-1090 Vienna, Austria

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Bruno Niederle
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, as ‘well differentiated’ tumours with either ‘benign’ or ‘uncertain’ behaviour or as ‘well differentiated’ or ‘poorly differentiated’ neuroendocrine carcinomas. Neuroendocrine liver tumours were included in the analysis if no other neuroendocrine

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S Felder Medizinische Klinik mit Schwerpunkt Hepatologie und Gastroenterologie (einschl. Arbeitsbereich Stoffwechselerkrankungen), Charité – Universitätsmedizin Berlin, Campus Virchow-Klinikum, Berlin, Germany

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H Jann Medizinische Klinik mit Schwerpunkt Hepatologie und Gastroenterologie (einschl. Arbeitsbereich Stoffwechselerkrankungen), Charité – Universitätsmedizin Berlin, Campus Virchow-Klinikum, Berlin, Germany

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R Arsenic Institut für Pathologie, Charité – Universitätsmedizin Berlin, Campus Mitte, Berlin, Germany

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T Denecke Klinik für Radiologie, Charité – Universitätsmedizin Berlin, Campus Virchow-Klinikum, Berlin, Germany

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V Prasad Klinik für Nuklearmedizin, Charité – Universitätsmedizin Berlin, Campus Virchow-Klinikum, Berlin, Germany
Klinik für Nuklearmedizin, Universitätklinikum Ulm, Ulm, Germany

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B Knappe-Drzikova Medizinische Klinik mit Schwerpunkt Hepatologie und Gastroenterologie (einschl. Arbeitsbereich Stoffwechselerkrankungen), Charité – Universitätsmedizin Berlin, Campus Virchow-Klinikum, Berlin, Germany

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S Maasberg Medizinische Klinik mit Schwerpunkt Hepatologie und Gastroenterologie (einschl. Arbeitsbereich Stoffwechselerkrankungen), Charité – Universitätsmedizin Berlin, Campus Virchow-Klinikum, Berlin, Germany
Innere Medizin und Gastroenterologie, Asklepios Klinik St. Georg, Asklepios Medical School, Hamburg, Germany

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B Wiedenmann Medizinische Klinik mit Schwerpunkt Hepatologie und Gastroenterologie (einschl. Arbeitsbereich Stoffwechselerkrankungen), Charité – Universitätsmedizin Berlin, Campus Virchow-Klinikum, Berlin, Germany

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M Pavel Medizinische Klinik mit Schwerpunkt Hepatologie und Gastroenterologie (einschl. Arbeitsbereich Stoffwechselerkrankungen), Charité – Universitätsmedizin Berlin, Campus Virchow-Klinikum, Berlin, Germany
Medizinische Klinik 1, Gastroenterologie, Pneumologie und Endokrinologie, Universitätsklinikum der Friedrich-Alexander Universität Erlangen, Erlangen, Germany

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A Pascher Klinik für Allgemein-, Viszeral- und Transplantationschirurgie, Charité – Universitätsmedizin Berlin, Campus Virchow-Klinikum, Berlin, Germany
Klinik für Allgemein-, Viszeral- und Transplantationschirurgie, Uinversitätsklinikum Münster, Münster, Germany

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U F Pape Medizinische Klinik mit Schwerpunkt Hepatologie und Gastroenterologie (einschl. Arbeitsbereich Stoffwechselerkrankungen), Charité – Universitätsmedizin Berlin, Campus Virchow-Klinikum, Berlin, Germany
Innere Medizin und Gastroenterologie, Asklepios Klinik St. Georg, Asklepios Medical School, Hamburg, Germany

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://doi.org/10.1055/s-2003-37256 ) 12584637 Ishida M Sekine S Fukagawa T Ohashi M Morita S Taniguchi H Katai H Tsuda H Kushima R 2013 Neuroendocrine carcinoma of the stomach: morphologic and immunohistochemical characteristics and

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Krystallenia I Alexandraki Second Department of Surgery, Aretaieion Hospital, National and Kapodistrian University of Athens, Athens, Greece

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Ariadni Spyroglou Second Department of Surgery, Aretaieion Hospital, National and Kapodistrian University of Athens, Athens, Greece
Clinic for Endocrinology, Diabetology and Clinical Nutrition, University Hospital Zurich, Zurich, Switzerland

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Stylianos Kykalos Second Department of Propaedeutic Surgery, Laiko Hospital, National and Kapodistrian University of Athens, Medical School, Athens, Greece

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Kosmas Daskalakis Department of Surgery, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
Endocrine Unit, First Department of Propaedeutic Medicine, Laiko University Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece

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Georgios Kyriakopoulos Department of Pathology, Evaggelismos Hospital, Athens, Greece

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Georgios C Sotiropoulos Clinic for Endocrinology, Diabetology and Clinical Nutrition, University Hospital Zurich, Zurich, Switzerland

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Gregory A Kaltsas Endocrine Unit, First Department of Propaedeutic Medicine, Laiko University Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece

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Ashley B Grossman Oxford Centre for Diabetes, Endocrinology and Metabolism, Churchill Hospital, University of Oxford, Oxford, UK
NET Unit, Royal Free Hospital, London, UK
Barts and the London School of Medicine, London, UK

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reflect their biological behaviour, ranging from the well-differentiated neuroendocrine tumours (NETs) to the poorly differentiated neuroendocrine carcinomas (NECs) ( Nagtegaal et al. 2020 ). The Ki-67 protein is a cellular proliferation marker, useful

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Maria Chiara Zatelli Section of Endocrinology and Internal Medicine, Neuroendocrine Tumours Unit, Endocrinology Unit, Department of Clinical Medicine and Surgery, Thyroid and Parathyroid Surgery Unit, Department of Medical Sciences, University of Ferrara, Via Aldo Moro 8, 44124 Cona – Ferrara, Italy

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Giuseppe Fanciulli Section of Endocrinology and Internal Medicine, Neuroendocrine Tumours Unit, Endocrinology Unit, Department of Clinical Medicine and Surgery, Thyroid and Parathyroid Surgery Unit, Department of Medical Sciences, University of Ferrara, Via Aldo Moro 8, 44124 Cona – Ferrara, Italy

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Pasqualino Malandrino Section of Endocrinology and Internal Medicine, Neuroendocrine Tumours Unit, Endocrinology Unit, Department of Clinical Medicine and Surgery, Thyroid and Parathyroid Surgery Unit, Department of Medical Sciences, University of Ferrara, Via Aldo Moro 8, 44124 Cona – Ferrara, Italy

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Valeria Ramundo Section of Endocrinology and Internal Medicine, Neuroendocrine Tumours Unit, Endocrinology Unit, Department of Clinical Medicine and Surgery, Thyroid and Parathyroid Surgery Unit, Department of Medical Sciences, University of Ferrara, Via Aldo Moro 8, 44124 Cona – Ferrara, Italy

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Antongiulio Faggiano Section of Endocrinology and Internal Medicine, Neuroendocrine Tumours Unit, Endocrinology Unit, Department of Clinical Medicine and Surgery, Thyroid and Parathyroid Surgery Unit, Department of Medical Sciences, University of Ferrara, Via Aldo Moro 8, 44124 Cona – Ferrara, Italy

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Annamaria Colao Section of Endocrinology and Internal Medicine, Neuroendocrine Tumours Unit, Endocrinology Unit, Department of Clinical Medicine and Surgery, Thyroid and Parathyroid Surgery Unit, Department of Medical Sciences, University of Ferrara, Via Aldo Moro 8, 44124 Cona – Ferrara, Italy

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on behalf of NIKE Group
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considered. The search strategy included the following terms: ‘neuroendocrine tumour’, ‘neuroendocrine carcinoma’, ‘predictive’, ‘response’, ‘everolimus’, ‘temsirolimus’ or ‘rapamycin’. Additional studies were identified by reviewing the references of all

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Ashley K Clift Department of Surgery and Cancer, Imperial College London, London, UK
NHS Nightingale Hospital London, London, UK

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Andrea Frilling Department of Surgery and Cancer, Imperial College London, London, UK

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proliferative capacity and degree of differentiation into neuroendocrine tumours (NET) or neuroendocrine carcinoma (NEC) ( Rindi et al. 2007 ). The former is relatively indolent as compared to adenocarcinomas arising from the same organs but display stark

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Corinne Gérard Aix Marseille Univ, INSERM, MMG (U1251), Marseille Medical Genetics, Marseille, France

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Marie Lagarde Aix Marseille Univ, INSERM, MMG (U1251), Marseille Medical Genetics, Marseille, France

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Flora Poizat Medical Oncology Department, Paoli-Calmettes Institute CoE-ENETS, Marseille, France

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Sandrine Oziel-Taieb Medical Oncology Department, Paoli-Calmettes Institute CoE-ENETS, Marseille, France

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Vincent Garcia Molecular Biology Laboratory, Hospital La Conception, AP-HM, Marseille, France

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Catherine Roche Molecular Biology Laboratory, Hospital La Conception, AP-HM, Marseille, France

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Patricia Niccoli Medical Oncology Department, Paoli-Calmettes Institute CoE-ENETS, Marseille, France

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Anne Barlier Aix Marseille Univ, INSERM, MMG (U1251), Marseille Medical Genetics, Marseille, France
Molecular Biology Laboratory, Hospital La Conception, AP-HM, Marseille, France

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David Romano Aix Marseille Univ, INSERM, MMG (U1251), Marseille Medical Genetics, Marseille, France

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progression free survival ( Pavel et al. 2011 , Yao et al. 2016 ). Cytotoxic agents are recommended in the ENETS consensus Guidelines for patients with poorly differentiated neuroendocrine carcinomas (NECs), as well as for those with well

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Tobias Hofving Department of Laboratory Medicine, Institute of Biomedicine, Sahlgrenska Cancer Center, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden

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Viktor Sandblom Department of Radiation Physics, Institute of Clinical Sciences, Sahlgrenska Cancer Center, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden

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Yvonne Arvidsson Department of Laboratory Medicine, Institute of Biomedicine, Sahlgrenska Cancer Center, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden

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Emman Shubbar Department of Radiation Physics, Institute of Clinical Sciences, Sahlgrenska Cancer Center, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden

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Gülay Altiparmak Department of Laboratory Medicine, Institute of Biomedicine, Sahlgrenska Cancer Center, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden

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John Swanpalmer Department of Radiation Physics, Institute of Clinical Sciences, Sahlgrenska Cancer Center, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
Department of Medical Physics and Biomedical Engineering, Sahlgrenska University Hospital, Gothenburg, Sweden

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Bilal Almobarak Department of Laboratory Medicine, Institute of Biomedicine, Sahlgrenska Cancer Center, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden

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Anna-Karin Elf Department of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden

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Viktor Johanson Department of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden

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Erik Elias Department of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden

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Erik Kristiansson Department of Mathematical Sciences, Chalmers University of Technology, Gothenburg, Sweden

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Eva Forssell-Aronsson Department of Radiation Physics, Institute of Clinical Sciences, Sahlgrenska Cancer Center, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
Department of Medical Physics and Biomedical Engineering, Sahlgrenska University Hospital, Gothenburg, Sweden

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Ola Nilsson Department of Laboratory Medicine, Institute of Biomedicine, Sahlgrenska Cancer Center, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden

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disease. In fact, P-STS was established from the primary tumour of a grade 3 poorly differentiated neuroendocrine carcinoma ( Pfragner et al. 2009 ). GOT1 and ex vivo cultures were unlike P-STS established from metastatic grade 1 or 2 well

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Darren Cowzer Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA

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Ronak H Shah Kravis Center for Molecular Oncology, Memorial Sloan Kettering Cancer Center, New York, New York, USA

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Joanne F Chou Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York, USA

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Ritika Kundra Kravis Center for Molecular Oncology, Memorial Sloan Kettering Cancer Center, New York, New York, USA

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Sippy Punn Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA

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Laura Fiedler Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA

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April DeMore Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA

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Marinela Capanu Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York, USA

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Michael F Berger Kravis Center for Molecular Oncology, Memorial Sloan Kettering Cancer Center, New York, New York, USA
Department of Pathology and laboratory medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA

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Diane Reidy-Lagunes Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA
Weill Medical College of Cornell University, New York, New York, USA

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Nitya Raj Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA
Weill Medical College of Cornell University, New York, New York, USA

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neuroendocrine tumor (WD-NET) and poorly differentiated neuroendocrine carcinoma (PD-NEC) of the pancreas . American Journal of Surgical Pathology 40 1192 – 1202 . ( https://doi.org/10.1097/PAS.0000000000000662 ) Tie J Cohen JD Lahouel K Lo SN Wang Y

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