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O Hentic Pôle des Maladies de l'Appareil Digestif, Service de Pathologie, Service de Radiologie, Pôle des Maladies de l'Appareil Digestif, Service de Gastroentérologie-Pancréatologie

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A Couvelard Pôle des Maladies de l'Appareil Digestif, Service de Pathologie, Service de Radiologie, Pôle des Maladies de l'Appareil Digestif, Service de Gastroentérologie-Pancréatologie

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V Rebours Pôle des Maladies de l'Appareil Digestif, Service de Pathologie, Service de Radiologie, Pôle des Maladies de l'Appareil Digestif, Service de Gastroentérologie-Pancréatologie

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M Zappa Pôle des Maladies de l'Appareil Digestif, Service de Pathologie, Service de Radiologie, Pôle des Maladies de l'Appareil Digestif, Service de Gastroentérologie-Pancréatologie

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S Dokmak Pôle des Maladies de l'Appareil Digestif, Service de Pathologie, Service de Radiologie, Pôle des Maladies de l'Appareil Digestif, Service de Gastroentérologie-Pancréatologie

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P Hammel Pôle des Maladies de l'Appareil Digestif, Service de Pathologie, Service de Radiologie, Pôle des Maladies de l'Appareil Digestif, Service de Gastroentérologie-Pancréatologie

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F Maire Pôle des Maladies de l'Appareil Digestif, Service de Pathologie, Service de Radiologie, Pôle des Maladies de l'Appareil Digestif, Service de Gastroentérologie-Pancréatologie

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D O'Toole Pôle des Maladies de l'Appareil Digestif, Service de Pathologie, Service de Radiologie, Pôle des Maladies de l'Appareil Digestif, Service de Gastroentérologie-Pancréatologie

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P Lévy Pôle des Maladies de l'Appareil Digestif, Service de Pathologie, Service de Radiologie, Pôle des Maladies de l'Appareil Digestif, Service de Gastroentérologie-Pancréatologie

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A Sauvanet Pôle des Maladies de l'Appareil Digestif, Service de Pathologie, Service de Radiologie, Pôle des Maladies de l'Appareil Digestif, Service de Gastroentérologie-Pancréatologie

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P Ruszniewski Pôle des Maladies de l'Appareil Digestif, Service de Pathologie, Service de Radiologie, Pôle des Maladies de l'Appareil Digestif, Service de Gastroentérologie-Pancréatologie

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guidelines for the management of patients with digestive neuroendocrine tumors – well-differentiated jejunal–ileal tumor/carcinoma . Neuroendocrinology 87 8 – 19 doi:10.1159/000111034 . Faggiano A Mansueto G Ferolla P Milone F del Basso de Caro

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Vincenzo Marotta Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy

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Maria Chiara Zatelli Section of Endocrinology and Internal Medicine, Department of Medical Sciences, University of Ferrara, Ferrara, Italy

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Concetta Sciammarella IOS & COLEMAN Srl, Naples, Italy

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Maria Rosaria Ambrosio Section of Endocrinology and Internal Medicine, Department of Medical Sciences, University of Ferrara, Ferrara, Italy

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Marta Bondanelli Section of Endocrinology and Internal Medicine, Department of Medical Sciences, University of Ferrara, Ferrara, Italy

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Annamaria Colao Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy

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Antongiulio Faggiano Thyroid and Parathyroid Surgery Unit, Istituto Nazionale per lo Studio e la Cura dei Tumori ‘Fondazione G. Pascale’ – IRCCS, Naples, Italy

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thyroid carcinoma Not defined (failed ROC analysis) Not defined (failed ROC analysis) GEP, gastroenteropancreatic; NEN, neuroendocrine neoplasm; ROC, receiving-operator characteristics. Sensitivity Sensitivity of

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Matthew H Kulke Department of Medical Oncology, Dana-Farber Cancer Institute and Harvard Medical School, Dana-Farber Cancer Institute, 44 Binney Street, Boston, Massachusetts 02115, USA

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A, Nicklee T, Ho J et al. 2006 A phase II clinical and pharmacodynamic study of temsirolimus in advanced neuroendocrine carcinomas. British Journal of Cancer 95 1148 –1154. Engstrom P , Lavin P

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Perrine Raymond Endocrinology Department, CHRU de Brabois, Vandoeuvre Les Nancy, France

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Gérald Raverot Endocrinology Department, Reference Center for Rare Pituitary Diseases HYPO, “Groupement Hospitalier Est” Hospices Civils de Lyon, Bron, France
Inserm U1052, CNRS UMR5286, Claude Bernard Lyon 1 University, Cancer Research Center of Lyon, Lyon, France

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Mirela-Diana Ilie Inserm U1052, CNRS UMR5286, Claude Bernard Lyon 1 University, Cancer Research Center of Lyon, Lyon, France
Endocrinology Department, “C.I. Parhon” National Institute of Endocrinology, Bucharest, Romania

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‘pituitary carcinoma’ as defined by the WHO 2017 classification is now named ‘metastatic pituitary neuroendocrine tumor (PitNET)’. More importantly, the term ‘carcinoma’, and more precisely, neuroendocrine carcinoma (NEC), has other implications, referring to

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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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Esben Andreas Carlsen Department of Clinical Physiology, Nuclear Medicine & PET, Rigshospitalet, Copenhagen, Denmark
Department of Biomedical Sciences, Cluster for Molecular Imaging, University of Copenhagen, Copenhagen, Denmark

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Nicola Fazio Division of Gastrointestinal Medical Oncology and Neuroendocrine Tumors, IEO, European Institute of Oncology IRCCS, Milan, Italy

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Dan Granberg Department of Medical Sciences, Uppsala University, Uppsala, Sweden

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Simona Grozinsky-Glasberg Neuroendocrine Tumor Unit, Department of Endocrinology & Metabolism, Hadassah-Hebrew University Medical Center, Jerusalem, Israel

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Hojjat Ahmadzadehfar Department of Nuclear Medicine, University Hospital Bonn, Bonn, Germany

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Chiara Maria Grana Division of Nuclear Medicine, IEO, European Institute of Oncology IRCCS, Milan, Italy

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Wouter T Zandee Erasmus Medical Center, Rotterdam, The Netherlands

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Jaroslaw Cwikla Medical School, University of Warmia and Mazury, Olsztyn, Poland

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Martin A Walter Department of Nuclear Medicine, University Hospital of Geneva, Geneva, Switzerland

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Peter Sandor Oturai Department of Clinical Physiology, Nuclear Medicine & PET, Rigshospitalet, Copenhagen, Denmark

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Anja Rinke Department of Gastroenterology, University Hospital Gießen and Marburg, Marburg, Germany

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Andrew Weaver Department of Oncology, Churchill Hospital, Oxford, UK

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

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Sara Gritti Division of Gastrointestinal Medical Oncology and Neuroendocrine Tumors, IEO, European Institute of Oncology IRCCS, Milan, Italy

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Anne Kirstine Arveschoug Department of Nuclear Medicine and PET, Aarhus University Hospital, Aarhus, Denmark

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Amichay Meirovitz Department of Oncology and Radiation Therapy Unit, Hadassah-Hebrew University Medical Center, Jerusalem, Israel

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Ulrich Knigge Department of Biomedical Sciences, Cluster for Molecular Imaging, University of Copenhagen, Copenhagen, Denmark
Departments of Surgical Gastroenterology and Clinical Endocrinology, Rigshospitalet, Copenhagen, Denmark

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Halfdan Sorbye Department of Oncology, Haukeland University Hospital, Bergen, Norway
Department of Clinical Science, University of Bergen, Bergen, Norway

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according to the proliferation index Ki-67; ≤2% (Grade 1, G1), 3–20% (G2) and >20% (G3) ( Bosman et al . 2010 ). G1–G2 was collectively referred to as neuroendocrine tumors (NET) and G3 as neuroendocrine carcinoma (NEC). The classification is strongly

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Kjell Oberg Department of Endocrine Oncology, Department of Medical Sciences, University Hospital, Entrance 78, SE-751 85 Uppsala, Sweden
Department of Endocrine Oncology, Department of Medical Sciences, University Hospital, Entrance 78, SE-751 85 Uppsala, Sweden

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neuroendocrine tumours: well-differentiated colon and rectum tumour/carcinoma . Neuroendocrinology 87 31 – 39 . doi:10.1159/000111036 . Rindi G Kloppel G Couvelard A Komminoth P Korner M Lopes JM McNicol AM Nilsson O Perren A Scarpa A

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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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Aura D Herrera-Martínez Division of Endocrinology, Department of Internal Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
Maimonides Institute for Biomedical Research of Cordoba (IMIBIC); Reina Sofia University Hospital, Córdoba, Spain

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Leo J Hofland Division of Endocrinology, Department of Internal Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands

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María A Gálvez Moreno Maimonides Institute for Biomedical Research of Cordoba (IMIBIC); Reina Sofia University Hospital, Córdoba, Spain

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Justo P Castaño Maimonides Institute for Biomedical Research of Cordoba (IMIBIC); Reina Sofia University Hospital, Córdoba, Spain

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Wouter W de Herder Division of Endocrinology, Department of Internal Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands

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Richard A Feelders Division of Endocrinology, Department of Internal Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands

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Neuroendocrine Tumor Society; ESMO, European Society of Medical Oncology; Gut-NENs include tumors in the jejunum, ileum, appendix, and cecum; NANETS, North American Neuroendocrine Tumor; NCCN, National Comprehensive Cancer Network; NEC, neuroendocrine carcinoma

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Vivian Rosery Bridge Institute of Experimental Tumor Therapy, West German Cancer Center, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
Department of Medical Oncology, West German Cancer Center, University Hospital Essen, University of Duisburg-Essen, Essen, Germany

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Henning Reis Institute of Pathology, West German Cancer Center, University Hospital Essen, University of Duisburg-Essen, Essen, Germany

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Konstantinos Savvatakis Bridge Institute of Experimental Tumor Therapy, West German Cancer Center, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
Division of Solid Tumor Translational Oncology, German Cancer Consortium (DKTK), Partner site University Hospital Essen, and German Cancer Research Center (DKFZ), Heidelberg, Germany

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Bernd Kowall Center of Clinical Epidemiology, Institute for Medical Informatics, Biometry and Epidemiology, Medical Faculty, University Duisburg-Essen, Essen, Germany

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Martin Stuschke Department of Radiotherapy, West German Cancer Center, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
German Cancer Consortium (DKTK), Partner site University Hospital Essen, Essen, Germany

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Andreas Paul German Cancer Consortium (DKTK), Partner site University Hospital Essen, Essen, Germany
General, Visceral and Transplantation Surgery, University Hospital Essen, University of Duisburg-Essen, Essen, Germany

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Alexander Dechêne Department of Gastroenterology and Hepatology, West German Cancer Center, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
Department of Internal Medicine 6, Paracelsus Medical University, Nürnberg, Germany

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JiaJin Yang Bridge Institute of Experimental Tumor Therapy, West German Cancer Center, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
Division of Solid Tumor Translational Oncology, German Cancer Consortium (DKTK), Partner site University Hospital Essen, and German Cancer Research Center (DKFZ), Heidelberg, Germany

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Ben Zhao Bridge Institute of Experimental Tumor Therapy, West German Cancer Center, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
Division of Solid Tumor Translational Oncology, German Cancer Consortium (DKTK), Partner site University Hospital Essen, and German Cancer Research Center (DKFZ), Heidelberg, Germany

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Arianna Borgers Bridge Institute of Experimental Tumor Therapy, West German Cancer Center, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
Division of Solid Tumor Translational Oncology, German Cancer Consortium (DKTK), Partner site University Hospital Essen, and German Cancer Research Center (DKFZ), Heidelberg, Germany

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Stefan Kasper Department of Medical Oncology, West German Cancer Center, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
German Cancer Consortium (DKTK), Partner site University Hospital Essen, Essen, Germany

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Martin Schuler Department of Medical Oncology, West German Cancer Center, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
German Cancer Consortium (DKTK), Partner site University Hospital Essen, Essen, Germany

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Phyllis F Cheung Bridge Institute of Experimental Tumor Therapy, West German Cancer Center, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
Division of Solid Tumor Translational Oncology, German Cancer Consortium (DKTK), Partner site University Hospital Essen, and German Cancer Research Center (DKFZ), Heidelberg, Germany

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Jens T Siveke Bridge Institute of Experimental Tumor Therapy, West German Cancer Center, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
Department of Medical Oncology, West German Cancer Center, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
Division of Solid Tumor Translational Oncology, German Cancer Consortium (DKTK), Partner site University Hospital Essen, and German Cancer Research Center (DKFZ), Heidelberg, Germany
German Cancer Consortium (DKTK), Partner site University Hospital Essen, Essen, Germany

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activity in well-differentiated tumors (G1–G2; Ki-67 ≤ 20%) and poorly differentiated neuroendocrine carcinomas (G3; Ki-67 > 20%) ( Bosman et al. 2010 ). However, neuroendocrine carcinomas (NEC) are no longer considered a homogenous entity. Several

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