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Igryl S Cordero-Hernandez Department of Gastrointestinal Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA

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Alicia C Ross Department of Gastrointestinal Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA

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Arvind Dasari Department of Gastrointestinal Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA

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Daniel M Halperin Department of Gastrointestinal Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA

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Beth Chasen Department of Nuclear Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA

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James C Yao Department of Gastrointestinal Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA

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). In the gastrointestinal and pancreatobiliary tracts, NEN are divided into well differentiated neuroendocrine tumors (NET) and poorly differentiated neuroendocrine carcinomas (NEC). NET are classified as G1, G2, and G3 based on tumor proliferation

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J Hadoux Departments of Nuclear Medicine and Endocrine Tumors, Digestive Oncology, Medical Oncology (Thoracic Group), Pathology, Radiology, Centre Antoine Lacassagne, Department of Urologic Oncology, Department of Endocrinology, Department of Biostatistics and Epidemiology, Faculté de Médecine, Gustave Roussy, 114 Rue Edouard Vaillant, F-94800 Villejuif Cedex, France

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D Malka Departments of Nuclear Medicine and Endocrine Tumors, Digestive Oncology, Medical Oncology (Thoracic Group), Pathology, Radiology, Centre Antoine Lacassagne, Department of Urologic Oncology, Department of Endocrinology, Department of Biostatistics and Epidemiology, Faculté de Médecine, Gustave Roussy, 114 Rue Edouard Vaillant, F-94800 Villejuif Cedex, France

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D Planchard Departments of Nuclear Medicine and Endocrine Tumors, Digestive Oncology, Medical Oncology (Thoracic Group), Pathology, Radiology, Centre Antoine Lacassagne, Department of Urologic Oncology, Department of Endocrinology, Department of Biostatistics and Epidemiology, Faculté de Médecine, Gustave Roussy, 114 Rue Edouard Vaillant, F-94800 Villejuif Cedex, France

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J Y Scoazec Departments of Nuclear Medicine and Endocrine Tumors, Digestive Oncology, Medical Oncology (Thoracic Group), Pathology, Radiology, Centre Antoine Lacassagne, Department of Urologic Oncology, Department of Endocrinology, Department of Biostatistics and Epidemiology, Faculté de Médecine, Gustave Roussy, 114 Rue Edouard Vaillant, F-94800 Villejuif Cedex, France

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C Caramella Departments of Nuclear Medicine and Endocrine Tumors, Digestive Oncology, Medical Oncology (Thoracic Group), Pathology, Radiology, Centre Antoine Lacassagne, Department of Urologic Oncology, Department of Endocrinology, Department of Biostatistics and Epidemiology, Faculté de Médecine, Gustave Roussy, 114 Rue Edouard Vaillant, F-94800 Villejuif Cedex, France

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J Guigay Departments of Nuclear Medicine and Endocrine Tumors, Digestive Oncology, Medical Oncology (Thoracic Group), Pathology, Radiology, Centre Antoine Lacassagne, Department of Urologic Oncology, Department of Endocrinology, Department of Biostatistics and Epidemiology, Faculté de Médecine, Gustave Roussy, 114 Rue Edouard Vaillant, F-94800 Villejuif Cedex, France

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V Boige Departments of Nuclear Medicine and Endocrine Tumors, Digestive Oncology, Medical Oncology (Thoracic Group), Pathology, Radiology, Centre Antoine Lacassagne, Department of Urologic Oncology, Department of Endocrinology, Department of Biostatistics and Epidemiology, Faculté de Médecine, Gustave Roussy, 114 Rue Edouard Vaillant, F-94800 Villejuif Cedex, France

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S Leboulleux Departments of Nuclear Medicine and Endocrine Tumors, Digestive Oncology, Medical Oncology (Thoracic Group), Pathology, Radiology, Centre Antoine Lacassagne, Department of Urologic Oncology, Department of Endocrinology, Department of Biostatistics and Epidemiology, Faculté de Médecine, Gustave Roussy, 114 Rue Edouard Vaillant, F-94800 Villejuif Cedex, France

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P Burtin Departments of Nuclear Medicine and Endocrine Tumors, Digestive Oncology, Medical Oncology (Thoracic Group), Pathology, Radiology, Centre Antoine Lacassagne, Department of Urologic Oncology, Department of Endocrinology, Department of Biostatistics and Epidemiology, Faculté de Médecine, Gustave Roussy, 114 Rue Edouard Vaillant, F-94800 Villejuif Cedex, France

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A Berdelou Departments of Nuclear Medicine and Endocrine Tumors, Digestive Oncology, Medical Oncology (Thoracic Group), Pathology, Radiology, Centre Antoine Lacassagne, Department of Urologic Oncology, Department of Endocrinology, Department of Biostatistics and Epidemiology, Faculté de Médecine, Gustave Roussy, 114 Rue Edouard Vaillant, F-94800 Villejuif Cedex, France

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Y Loriot Departments of Nuclear Medicine and Endocrine Tumors, Digestive Oncology, Medical Oncology (Thoracic Group), Pathology, Radiology, Centre Antoine Lacassagne, Department of Urologic Oncology, Department of Endocrinology, Department of Biostatistics and Epidemiology, Faculté de Médecine, Gustave Roussy, 114 Rue Edouard Vaillant, F-94800 Villejuif Cedex, France

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P Duvillard Departments of Nuclear Medicine and Endocrine Tumors, Digestive Oncology, Medical Oncology (Thoracic Group), Pathology, Radiology, Centre Antoine Lacassagne, Department of Urologic Oncology, Department of Endocrinology, Department of Biostatistics and Epidemiology, Faculté de Médecine, Gustave Roussy, 114 Rue Edouard Vaillant, F-94800 Villejuif Cedex, France

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C N Chougnet Departments of Nuclear Medicine and Endocrine Tumors, Digestive Oncology, Medical Oncology (Thoracic Group), Pathology, Radiology, Centre Antoine Lacassagne, Department of Urologic Oncology, Department of Endocrinology, Department of Biostatistics and Epidemiology, Faculté de Médecine, Gustave Roussy, 114 Rue Edouard Vaillant, F-94800 Villejuif Cedex, France

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D Déandréis Departments of Nuclear Medicine and Endocrine Tumors, Digestive Oncology, Medical Oncology (Thoracic Group), Pathology, Radiology, Centre Antoine Lacassagne, Department of Urologic Oncology, Department of Endocrinology, Department of Biostatistics and Epidemiology, Faculté de Médecine, Gustave Roussy, 114 Rue Edouard Vaillant, F-94800 Villejuif Cedex, France

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M Schlumberger Departments of Nuclear Medicine and Endocrine Tumors, Digestive Oncology, Medical Oncology (Thoracic Group), Pathology, Radiology, Centre Antoine Lacassagne, Department of Urologic Oncology, Department of Endocrinology, Department of Biostatistics and Epidemiology, Faculté de Médecine, Gustave Roussy, 114 Rue Edouard Vaillant, F-94800 Villejuif Cedex, France

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I Borget Departments of Nuclear Medicine and Endocrine Tumors, Digestive Oncology, Medical Oncology (Thoracic Group), Pathology, Radiology, Centre Antoine Lacassagne, Department of Urologic Oncology, Department of Endocrinology, Department of Biostatistics and Epidemiology, Faculté de Médecine, Gustave Roussy, 114 Rue Edouard Vaillant, F-94800 Villejuif Cedex, France
Departments of Nuclear Medicine and Endocrine Tumors, Digestive Oncology, Medical Oncology (Thoracic Group), Pathology, Radiology, Centre Antoine Lacassagne, Department of Urologic Oncology, Department of Endocrinology, Department of Biostatistics and Epidemiology, Faculté de Médecine, Gustave Roussy, 114 Rue Edouard Vaillant, F-94800 Villejuif Cedex, France

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M Ducreux Departments of Nuclear Medicine and Endocrine Tumors, Digestive Oncology, Medical Oncology (Thoracic Group), Pathology, Radiology, Centre Antoine Lacassagne, Department of Urologic Oncology, Department of Endocrinology, Department of Biostatistics and Epidemiology, Faculté de Médecine, Gustave Roussy, 114 Rue Edouard Vaillant, F-94800 Villejuif Cedex, France
Departments of Nuclear Medicine and Endocrine Tumors, Digestive Oncology, Medical Oncology (Thoracic Group), Pathology, Radiology, Centre Antoine Lacassagne, Department of Urologic Oncology, Department of Endocrinology, Department of Biostatistics and Epidemiology, Faculté de Médecine, Gustave Roussy, 114 Rue Edouard Vaillant, F-94800 Villejuif Cedex, France

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E Baudin Departments of Nuclear Medicine and Endocrine Tumors, Digestive Oncology, Medical Oncology (Thoracic Group), Pathology, Radiology, Centre Antoine Lacassagne, Department of Urologic Oncology, Department of Endocrinology, Department of Biostatistics and Epidemiology, Faculté de Médecine, Gustave Roussy, 114 Rue Edouard Vaillant, F-94800 Villejuif Cedex, France

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exhibit a very heterogeneous prognosis. Pathological differentiation or grading and TNM stage are the most important prognostic factors ( Baudin 2007 ). Poorly differentiated neuroendocrine carcinomas (NECs) are characterized by a poorer outcome when

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Julien Hadoux Oncologie Endocrinienne, Département d’Imagerie, Gustave Roussy, Villejuif, France

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Thomas Walter Service d’Oncologie, ENETS Centre of Excellence, Hospices Civils de Lyon et Université de Lyon, Lyon, France

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Christina Kanaan Service de Pathologie, Département de Biologie et Pathologie Médicale, Gustave Roussy, Villejuif, France

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Ségolène Hescot Département d’Oncologie, Institut Curie, Paris, France

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Vincent Hautefeuille Service d’Hépato-gastro-entérologie et Cancérologie Digestive, CHU Amiens Picardie, Amiens, France

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Marine Perrier Département d’Hépato-gastro-entérologie, CHU de Reims, Reims, France

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Igor Tauveron Service d'Endocrinologie, Diabétologie et Maladies Métaboliques, CHU Clermont-Ferrand, Clermont-Ferrand, France
Laboratoire GReD, Université Clermont Auvergne, Clermont-Ferrand, France

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Sandrine Laboureau Département d’Endocrinologie-Diabétologie-Nutrition, CHU d’Angers, Angers Cedex 9, France

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Christine Do Cao CHU de Lille, Service d’Endocrinologie, Lille, France

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Caroline Petorin CHU Clermont-Ferrand, Service de Chirurgie Digestive et Hépatobiliaire, Clermont-Ferrand, France

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Odile Blanchet CRB, CHU d’Angers, Angers Cedex 9, France

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Matthieu Faron Département de Chirurgie, Gustave Roussy, Villejuif, France

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Emmanuelle Leteurtre CANTHER - Cancer Heterogeneity Plasticity and Resistance to Therapies, Université de Lille, CNRS, Inserm, CHU Lille, UMR9020-U1277, Lille, France

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Marie-Christine Rousselet Département de Pathologie, CHU d’Angers, Angers Cedex 9, France

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Juliette Joubert Zakeyh Laboratoire d’Anatomie Pathologique, CHU Clermont-Ferrand, Clermont-Ferrand, France

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Aude Marchal Service d’Anatomo-Pathologie, CHU Reims, Reims, France

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Denis Chatelain Service d’Anatomo-Pathologie, CHU Amiens, Amiens, France

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Clément Beaulaton Service d’Anatomo-Pathologie, Institut Curie, Paris, France

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Valérie Hervieu Service d’Anatomo-Pathologie, ENETS Centre of Excellence, Hospices Civils de Lyon et Université de Lyon, Lyon, France

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Catherine Lombard-Bohas Service d’Oncologie, ENETS Centre of Excellence, Hospices Civils de Lyon et Université de Lyon, Lyon, France

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Michel Ducreux Service d’Oncologie Digestive, Département de Médecine, Gustave Roussy, Villejuif, France
Faculté de Médecine, Université Paris Saclay, Le Kremlin-Bicêtre, France

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Jean-Yves Scoazec Service de Pathologie, Département de Biologie et Pathologie Médicale, Gustave Roussy, Villejuif, France
Faculté de Médecine, Université Paris Saclay, Le Kremlin-Bicêtre, France

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Eric Baudin Oncologie Endocrinienne, Département d’Imagerie, Gustave Roussy, Villejuif, France

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the Groupe d’Etude des Tumeurs Endocrines (GTE)
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the ENDOCAN-RENATEN network
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Introduction Neuroendocrine carcinomas (NECs) are highly malignant diseases, which can occur in all organs and are defined by a poorly differentiated morphology and high proliferative capacities testified by a high Ki-67 index ( Rindi et al

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Atsuko Kasajima Department of Pathology, Technical University Munich, Munich, Germany
Department of Pathology, Tohoku University Graduate School of Medicine, Sendai, Japan

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Yuichi Ishikawa Pathology Department, The Cancer Institute Hospital of JFCR, Tokyo, Japan

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Ayaka Iwata Department of Pathology, Tohoku University Graduate School of Medicine, Sendai, Japan

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Katja Steiger Department of Pathology, Technical University Munich, Munich, Germany

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Naomi Oka Department of Pathology, Tohoku University Graduate School of Medicine, Sendai, Japan
National Hospital Organization, Sendai Medical Center, Sendai, Japan

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Hirotaka Ishida Department of Pathology, Tohoku University Graduate School of Medicine, Sendai, Japan

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Akira Sakurada Department of Thoracic Surgery, Institute of Development, Aging and Cancer, Tohoku University Graduate School of Medicine, Sendai, Japan

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Hiroyoshi Suzuki National Hospital Organization, Sendai Medical Center, Sendai, Japan

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Toru Kameya Division of Pathology, Shizuoka Cancer Center Hospital and Research Institute, Sizuoka, Japan

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Björn Konukiewitz Department of Pathology, Technical University Munich, Munich, Germany

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Günter Klöppel Department of Pathology, Technical University Munich, Munich, Germany

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Yoshinori Okada Department of Thoracic Surgery, Institute of Development, Aging and Cancer, Tohoku University Graduate School of Medicine, Sendai, Japan

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Hironobu Sasano Department of Pathology, Tohoku University Graduate School of Medicine, Sendai, Japan

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Wilko Weichert Department of Pathology, Technical University Munich, Munich, Germany
Member of the German Cancer Consortium (DKTK)

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Introduction Pulmonary neuroendocrine tumors, as defined in the 2015 classification of the World Health Organization (WHO), comprise three different types; carcinoid tumors, large cell neuroendocrine carcinomas (LCNEC) and small-cell lung

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Carmine Valenza Division of New Drugs and Early Drug Development for Innovative Therapies, European Institute of Oncology, IRCCS, Via Ripamonti, Milan, Italy
Department of Oncology and Hemato-Oncology (DIPO), University of Milan, Milan, Italy

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Francesca Spada Division of Gastrointestinal Medical Oncology and Neuroendocrine Tumors, European Institute of Oncology, IEO, IRCCS, Via Ripamonti, Milan, Italy

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Francesco Multinu Division of Gynecologic Surgery, European Institute of Oncology, IRCCS, Via Ripamonti, Milan, Italy

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Lavinia Benini Division of Gastrointestinal Medical Oncology and Neuroendocrine Tumors, European Institute of Oncology, IEO, IRCCS, Via Ripamonti, Milan, Italy

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Michele Borghesani Division of Gastrointestinal Medical Oncology and Neuroendocrine Tumors, European Institute of Oncology, IEO, IRCCS, Via Ripamonti, Milan, Italy

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Laura Algeri Division of Gastrointestinal Medical Oncology and Neuroendocrine Tumors, European Institute of Oncology, IEO, IRCCS, Via Ripamonti, Milan, Italy

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Manila Rubino Division of Gastrointestinal Medical Oncology and Neuroendocrine Tumors, European Institute of Oncology, IEO, IRCCS, Via Ripamonti, Milan, Italy

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Eleonora Pisa Division of Pathology and Laboratory Medicine, European Institute of Oncology, IRCCS, Via Ripamonti, Milan, Italy

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Lorenzo Gervaso Division of Gastrointestinal Medical Oncology and Neuroendocrine Tumors, European Institute of Oncology, IEO, IRCCS, Via Ripamonti, Milan, Italy

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Chiara Alessandra Cella Division of Gastrointestinal Medical Oncology and Neuroendocrine Tumors, European Institute of Oncology, IEO, IRCCS, Via Ripamonti, Milan, Italy

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Silvestro Carinelli Division of Pathology and Laboratory Medicine, European Institute of Oncology, IRCCS, Via Ripamonti, Milan, Italy

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Simone Bruni Division of Gynecologic Surgery, European Institute of Oncology, IRCCS, Via Ripamonti, Milan, Italy

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Gabriella Schivardi Division of Gynecologic Surgery, European Institute of Oncology, IRCCS, Via Ripamonti, Milan, Italy

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Giuseppe Curigliano Division of New Drugs and Early Drug Development for Innovative Therapies, European Institute of Oncology, IRCCS, Via Ripamonti, Milan, Italy
Department of Oncology and Hemato-Oncology (DIPO), University of Milan, Milan, Italy

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Vanna Zanagnolo Division of Gynecologic Surgery, European Institute of Oncology, IRCCS, Via Ripamonti, Milan, Italy

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Giovanni Aletti Department of Oncology and Hemato-Oncology (DIPO), University of Milan, Milan, Italy
Division of Gynecologic Surgery, European Institute of Oncology, IRCCS, Via Ripamonti, Milan, Italy

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Nicoletta Colombo Division of Gynecologic Oncology, European Institute of Oncology, IRCCS, Via Ripamonti, Milan, Italy
Department of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy

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

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Introduction High-grade neuroendocrine carcinoma of the cervix (NECC) is a rare subtype of invasive cervical carcinoma, accounting for 1.4% of all cases of cervical carcinoma and displaying an extremely aggressive biological behavior, with a

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Jennifer R Eads Division of Hematology and Oncology, Abramson Cancer Center, University of Pennsylvania, Pennsylvania, USA

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Thorvardur R Halfdanarson Division of Medical Oncology, Mayo Clinic Cancer Center, Rochester, Minnesota, USA

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Tim Asmis Division of Medical Oncology, University of Ottawa, Ottawa, Ontario, Canada

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Andrew M Bellizzi Department of Pathology, University of Iowa Carver College of Medicine, Iowa City, Iowa, USA

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Emily K Bergsland Department of Medicine, University of California, San Francisco, California, USA

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Arvind Dasari Division of Gastrointestinal Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA

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Ghassan El-Haddad Department of Diagnostic Imaging and Interventional Radiology, Moffitt Cancer Center and Research Institute, Tampa, Florida, USA

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Michael Frumovitz Division of Gynecologic Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA

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Joshua Meyer Department of Radiation Oncology, Fox Chase Cancer Center, Philadelphia, Pennsylvania, USA

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Erik Mittra Division of Molecular Imaging and Therapy, Oregon Health & Science University, Portland, Oregon, USA

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Sten Myrehaug Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada

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Eric Nakakura Department of Surgery, University of California, San Francisco, California, USA

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Nitya Raj Department of Medicine, Gastrointestinal Oncology Service, Memorial Sloan Kettering Cancer Center, New York, New York, USA

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Heloisa P Soares Division of Oncology, Huntsman Cancer Institute, University of Utah, Salt Lake City, Salt Lake City, Utah, USA

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Brian Untch Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York, USA

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Namrata Vijayvergia Department of Hematology and Oncology, Fox Chase Cancer Center, Philadelphia, Pennsylvania, USA

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Jennifer A Chan Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA

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-differentiated high-grade neuroendocrine tumors (G3 NET) and poorly differentiated high-grade neuroendocrine carcinomas (NECs). Most available literature does not account for this subcategorization and as a result, much of the management of high-grade NENs is based on

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Nora Sahnane Section of Anatomic Pathology, CRIBI Biotechnology Center, Department of Molecular Medicine, Department of Pathology, Department of Surgical and Morphological Sciences, University of Insubria, Via O. Rossi, 9, 21100 Varese, Italy

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Daniela Furlan Section of Anatomic Pathology, CRIBI Biotechnology Center, Department of Molecular Medicine, Department of Pathology, Department of Surgical and Morphological Sciences, University of Insubria, Via O. Rossi, 9, 21100 Varese, Italy

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Matilde Monti Section of Anatomic Pathology, CRIBI Biotechnology Center, Department of Molecular Medicine, Department of Pathology, Department of Surgical and Morphological Sciences, University of Insubria, Via O. Rossi, 9, 21100 Varese, Italy

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Chiara Romualdi Section of Anatomic Pathology, CRIBI Biotechnology Center, Department of Molecular Medicine, Department of Pathology, Department of Surgical and Morphological Sciences, University of Insubria, Via O. Rossi, 9, 21100 Varese, Italy

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Alessandro Vanoli Section of Anatomic Pathology, CRIBI Biotechnology Center, Department of Molecular Medicine, Department of Pathology, Department of Surgical and Morphological Sciences, University of Insubria, Via O. Rossi, 9, 21100 Varese, Italy

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Emanuela Vicari Section of Anatomic Pathology, CRIBI Biotechnology Center, Department of Molecular Medicine, Department of Pathology, Department of Surgical and Morphological Sciences, University of Insubria, Via O. Rossi, 9, 21100 Varese, Italy

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Enrico Solcia Section of Anatomic Pathology, CRIBI Biotechnology Center, Department of Molecular Medicine, Department of Pathology, Department of Surgical and Morphological Sciences, University of Insubria, Via O. Rossi, 9, 21100 Varese, Italy

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Carlo Capella Section of Anatomic Pathology, CRIBI Biotechnology Center, Department of Molecular Medicine, Department of Pathology, Department of Surgical and Morphological Sciences, University of Insubria, Via O. Rossi, 9, 21100 Varese, Italy

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Fausto Sessa Section of Anatomic Pathology, CRIBI Biotechnology Center, Department of Molecular Medicine, Department of Pathology, Department of Surgical and Morphological Sciences, University of Insubria, Via O. Rossi, 9, 21100 Varese, Italy

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Stefano La Rosa Section of Anatomic Pathology, CRIBI Biotechnology Center, Department of Molecular Medicine, Department of Pathology, Department of Surgical and Morphological Sciences, University of Insubria, Via O. Rossi, 9, 21100 Varese, Italy

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Introduction High-grade (or poorly differentiated) gastroenteropancreatic (GEP) neuroendocrine carcinomas (NECs) are aggressive cancers with a high propensity for distant metastases. Like the more frequent pulmonary counterparts, they have

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Andrew McDonald Winship Cancer Institute at Emory University, Atlanta, Georgia, USA

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Vaidehi Avadhani Grady Memorial Hospital, Atlanta, Georgia, USA

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Gabriela Oprea-Ilies Grady Memorial Hospital, Atlanta, Georgia, USA

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Katerina Zakka Winship Cancer Institute at Emory University, Atlanta, Georgia, USA

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Gregory B Lesinski Winship Cancer Institute at Emory University, Atlanta, Georgia, USA

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Olumide B Gbolahan Winship Cancer Institute at Emory University, Atlanta, Georgia, USA

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Olatunji Alese Winship Cancer Institute at Emory University, Atlanta, Georgia, USA

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as neuroendocrine carcinoma (NEC). There is an inverse correlation between overall survival (OS) and tumor grade, with HG NEC having the worst prognosis among GEP-NEN subtypes ( Klimstra et al. 2019 ). GEP-NECs have an aggressive natural history

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M Heetfeld
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C N Chougnet Department of Hepatology and Gastroenterology, Department of Nuclear Medicine, Department of Surgical Gastroenterology, Department of Internal Medicine, Department of Gastroenterology, Department of Medical Oncology, Department of Medical Oncology, Department of Clinical Medicine and Gastroenterology, Department of Hepatology and Gastroenterology, Charité University Hospital Berlin, Berlin, Germany

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I H Olsen Department of Hepatology and Gastroenterology, Department of Nuclear Medicine, Department of Surgical Gastroenterology, Department of Internal Medicine, Department of Gastroenterology, Department of Medical Oncology, Department of Medical Oncology, Department of Clinical Medicine and Gastroenterology, Department of Hepatology and Gastroenterology, Charité University Hospital Berlin, Berlin, Germany

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A Rinke Department of Hepatology and Gastroenterology, Department of Nuclear Medicine, Department of Surgical Gastroenterology, Department of Internal Medicine, Department of Gastroenterology, Department of Medical Oncology, Department of Medical Oncology, Department of Clinical Medicine and Gastroenterology, Department of Hepatology and Gastroenterology, Charité University Hospital Berlin, Berlin, Germany

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I Borbath Department of Hepatology and Gastroenterology, Department of Nuclear Medicine, Department of Surgical Gastroenterology, Department of Internal Medicine, Department of Gastroenterology, Department of Medical Oncology, Department of Medical Oncology, Department of Clinical Medicine and Gastroenterology, Department of Hepatology and Gastroenterology, Charité University Hospital Berlin, Berlin, Germany

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G Crespo Department of Hepatology and Gastroenterology, Department of Nuclear Medicine, Department of Surgical Gastroenterology, Department of Internal Medicine, Department of Gastroenterology, Department of Medical Oncology, Department of Medical Oncology, Department of Clinical Medicine and Gastroenterology, Department of Hepatology and Gastroenterology, Charité University Hospital Berlin, Berlin, Germany

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J Barriuso Department of Hepatology and Gastroenterology, Department of Nuclear Medicine, Department of Surgical Gastroenterology, Department of Internal Medicine, Department of Gastroenterology, Department of Medical Oncology, Department of Medical Oncology, Department of Clinical Medicine and Gastroenterology, Department of Hepatology and Gastroenterology, Charité University Hospital Berlin, Berlin, Germany

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M Pavel
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D O'Toole Department of Hepatology and Gastroenterology, Department of Nuclear Medicine, Department of Surgical Gastroenterology, Department of Internal Medicine, Department of Gastroenterology, Department of Medical Oncology, Department of Medical Oncology, Department of Clinical Medicine and Gastroenterology, Department of Hepatology and Gastroenterology, Charité University Hospital Berlin, Berlin, Germany

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T Walter Department of Hepatology and Gastroenterology, Department of Nuclear Medicine, Department of Surgical Gastroenterology, Department of Internal Medicine, Department of Gastroenterology, Department of Medical Oncology, Department of Medical Oncology, Department of Clinical Medicine and Gastroenterology, Department of Hepatology and Gastroenterology, Charité University Hospital Berlin, Berlin, Germany

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other Knowledge Network members
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a Ki-67 index ranging from 20 to 55% and those with a Ki-67 index above 55%. According to the current World Health Organization (WHO) 2010 Classification, neuroendocrine carcinoma (NEC) is defined by both a poorly differentiated morphology (large

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Mairéad G McNamara Department of Medical Oncology, The Christie NHS Foundation Trust, Manchester, UK
Division of Cancer Sciences, University of Manchester, Manchester, UK

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Jean-Yves Scoazec Department of Pathology, Gustave Roussy Cancer Campus, Villejuif, France
Université Paris Sud, Faculté de Médecine de Bicêtre, Le Kremlin-Bicêtre, France

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Thomas Walter Department of Gastroenterology and Medical Oncology, Edouard Herriot Hospital, Hospices Civils de Lyon, Lyon, France

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Introduction High grade neuroendocrine carcinomas (NECs) are usually defined by the combination of a poorly differentiated tumour cell morphology and evidence of high proliferative activity, evaluated either directly through the mitotic index

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