{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T21:01:07Z","timestamp":1791838867932,"version":"4.3.4"},"reference-count":24,"publisher":"Bioscientifica","issue":"6","license":[{"start":{"date-parts":[[2022,6,1]],"date-time":"2022-06-01T00:00:00Z","timestamp":1654041600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["ec.bioscientifica.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2022,6,1]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To improve neuroendocrine neoplasm (NEN) management, the European Neuroendocrine Tumor Society (ENETS) recognised 62 Centers of Excellence (CoE). This retrospective study compares conformity of patients\u2019 initial management within vs outside an ENETS CoE with clinical practice guidelines (CPGs).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Patients diagnosed with a NEN between August 2018 and July 2020 and presented in the Lyon-CoE Multidisciplinary Tumour Board (MDT) were included. Factors potentially associated with the conformity of initial management (work-up and first treatment) to CPG underwent univariate and multivariate analyses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among the 615 included patients, 170 (27.6%) were initially managed in the CoE and 445 (72.4%) were only presented at the CoE-MDT. Patients in the CoE group more often had intestinal or pancreatic primaries, metastatic disease (61.8% vs 33%), hereditary syndrome, and a functioning tumour. Work-up conformity was 37.1% in the CoE (vs 29.9%,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009\u2009=\u20090.09); this was 95.8% for the first treatment (vs 88.7%,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009\u2009=\u20090.01). After multivariate analysis, CPG conformity was significantly higher for patients managed in the CoE, for younger patients, for those having a grade 1\u20132 tumour, and a genetic syndrome. Pancreatic and small intestinal (SI) NET surgeries performed in the CoE had a higher splenic preservation rate during left pancreatectomy, better detection of multiple tumours in SI surgeries, and higher number of resected lymph nodes.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Given the widespread observance of CPG, not all patients require management in the CoE. Referral should be considered for more complex cases such as metastatic diseases, G2 tumours, or carcinoid syndromes. Finally, we should encourage the centralization of NET surgery.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1530\/ec-22-0097","type":"journal-article","created":{"date-parts":[[2022,5,6]],"date-time":"2022-05-06T06:54:45Z","timestamp":1651820085000},"update-policy":"https:\/\/doi.org\/10.1530\/crossmarkpolicy-10","source":"Crossref","is-referenced-by-count":9,"title":["Management of neuroendocrine neoplasms: conformity with guidelines in and outside a center of excellence"],"prefix":"10.1530","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8720-9426","authenticated-orcid":true,"given":"Carole","family":"Morin","sequence":"first","affiliation":[{"name":"Hospices Civils de Lyon, H\u00f4pital Edouard Herriot, Oncologie Digestive, Lyon Cedex 03, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keo-Morakort","family":"Benedetto","sequence":"additional","affiliation":[{"name":"Hospices Civils de Lyon, H\u00f4pital Edouard Herriot, Oncologie Digestive, Lyon Cedex 03, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Agathe","family":"Deville","sequence":"additional","affiliation":[{"name":"Hospices Civils de Lyon, H\u00f4pital Louis Pradel, M\u00e9decine Nucl\u00e9aire, Bron, France"},{"name":"Centre de Recherche en Canc\u00e9rologie de Lyon, UMR Inserm 1052 CNRS 5286, Lyon Cedex 08, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laurent","family":"Milot","sequence":"additional","affiliation":[{"name":"Hospices Civils de Lyon, H\u00f4pital Edouard Herriot, Radiologie, Lyon Cedex 03, France"},{"name":"University of Lyon, Universit\u00e9 Lyon 1, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aur\u00e9lie","family":"Theillaumas","sequence":"additional","affiliation":[{"name":"Hospices Civils de Lyon, H\u00f4pital Edouard Herriot, Oncologie Digestive, Lyon Cedex 03, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Val\u00e9rie","family":"Hervieu","sequence":"additional","affiliation":[{"name":"Centre de Recherche en Canc\u00e9rologie de Lyon, UMR Inserm 1052 CNRS 5286, Lyon Cedex 08, France"},{"name":"University of Lyon, Universit\u00e9 Lyon 1, France"},{"name":"Hospices Civils de Lyon, Institut de Pathologie Est, Bron Cedex, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mathieu","family":"Pioche","sequence":"additional","affiliation":[{"name":"University of Lyon, Universit\u00e9 Lyon 1, France"},{"name":"Hospices Civils de Lyon, H\u00f4pital Edouard Herriot, Gastroent\u00e9rologie, Lyon Cedex 03, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gilles","family":"Poncet","sequence":"additional","affiliation":[{"name":"Centre de Recherche en Canc\u00e9rologie de Lyon, UMR Inserm 1052 CNRS 5286, Lyon Cedex 08, France"},{"name":"University of Lyon, Universit\u00e9 Lyon 1, France"},{"name":"Hospices Civils de Lyon, H\u00f4pital Edouard Herriot, Chirurgie Digestive, Lyon Cedex 03, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julien","family":"Forestier","sequence":"additional","affiliation":[{"name":"Hospices Civils de Lyon, H\u00f4pital Edouard Herriot, Oncologie Digestive, Lyon Cedex 03, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laurent","family":"Fran\u00e7ois","sequence":"additional","affiliation":[{"name":"Hospices Civils de Lyon, H\u00f4pital Louis Pradel, Exploration Fonctionnelle, Bron Cedex, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2515-7840","authenticated-orcid":true,"given":"Francoise","family":"Borson-Chazot","sequence":"additional","affiliation":[{"name":"University of Lyon, Universit\u00e9 Lyon 1, France"},{"name":"Hospices Civils de Lyon, H\u00f4pital Louis Pradel, Endocrinologie, Bron Cedex, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mustapha","family":"Adham","sequence":"additional","affiliation":[{"name":"University of Lyon, Universit\u00e9 Lyon 1, France"},{"name":"Hospices Civils de Lyon, H\u00f4pital Edouard Herriot, Chirurgie Digestive, Lyon Cedex 03, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catherine","family":"Lombard-Bohas","sequence":"additional","affiliation":[{"name":"Hospices Civils de Lyon, H\u00f4pital Edouard Herriot, Oncologie Digestive, Lyon Cedex 03, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4199-4561","authenticated-orcid":true,"given":"Thomas","family":"Walter","sequence":"additional","affiliation":[{"name":"Hospices Civils de Lyon, H\u00f4pital Edouard Herriot, Oncologie Digestive, Lyon Cedex 03, France"},{"name":"Centre de Recherche en Canc\u00e9rologie de Lyon, UMR Inserm 1052 CNRS 5286, Lyon Cedex 08, France"},{"name":"University 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