{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T21:01:09Z","timestamp":1791838869051,"version":"4.3.4"},"reference-count":81,"publisher":"MDPI AG","issue":"18","license":[{"start":{"date-parts":[[2023,9,6]],"date-time":"2023-09-06T00:00:00Z","timestamp":1693958400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Heinz-Horst Deichmann Foundation","award":["P31294"],"award-info":[{"award-number":["P31294"]}]},{"name":"Heinz-Horst Deichmann Foundation","award":["FP7-MC-IEF"],"award-info":[{"award-number":["FP7-MC-IEF"]}]},{"name":"European Union FP7","award":["P31294"],"award-info":[{"award-number":["P31294"]}]},{"name":"European Union FP7","award":["FP7-MC-IEF"],"award-info":[{"award-number":["FP7-MC-IEF"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Background: Neuroendocrine tumours (NET) arising from the small bowel are clinically challenging and are often diagnosed at advanced stages. Disease control with surgery alone can be demanding. Multimodal treatment concepts integrating surgery and non-surgical modalities could be of benefit. Method: Retrospective review of consecutive adult patients with SB NET treated at Imperial College Healthcare NHS Trust between 1 January 2010 and 31 December 2019. Data regarding clinicopathological characteristics, treatments, and disease trajectory were extracted and summarised. Overall and progression\/recurrence-free survival were estimated at 5 and 10 years. Results: 154 patients were identified, with a median age of 64 years (range 33\u201387); 135\/154 (87.7%) had stage III\/IV disease at diagnosis. Surgery was used in 125 individuals (81.2%), typically with either segmental small bowel resection (60.8%) or right hemicolectomy (33.6%) and mesenteric lymphadenectomy for the primary tumour. Systemic and\/or liver-directed therapies were used in 126 (81.8%); 60 (47.6%) had more than one line of non-surgical treatment. Median follow-up was 67.2 months (range 3.1\u2013310.4); overall survival at 5 and 10 years was 91.0% (95% CI: 84.9\u201394.7%) and 82.5% (95% CI: 72.9\u201388.9%), respectively. Imaging-based median progression-free survival was 42.7 months (95% CI: 24.7 to 72.4); 5-year progression-free survival was 63.4% (95% CI: 55.0\u201370.6%); 10-year progression-free survival was 18.7% (95% CI: 12.4\u201326.1). Nineteen patients (12.3%) reached 10 years follow-up without disease recurrence and therefore were considered cured. Conclusions: Most patients with SB NET present in a metastasised stage. Multimodal treatment concepts may be associated with excellent clinical outcomes. Future work should explore optimal approaches to treatment sequencing and patient selection.<\/jats:p>","DOI":"10.3390\/cancers15184438","type":"journal-article","created":{"date-parts":[[2023,9,6]],"date-time":"2023-09-06T10:23:42Z","timestamp":1693995822000},"page":"4438","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Management of Small Bowel Neuroendocrine Tumours: 10 Years\u2019 Experience at a Tertiary Referral Centre"],"prefix":"10.3390","volume":"15","author":[{"given":"Ashley K.","family":"Clift","sequence":"first","affiliation":[{"name":"Department of Surgery and Cancer, Imperial College London, Hammersmith Campus, Du Cane Road, London W12 0HS, UK"},{"name":"CRUK Oxford Centre, Department of Oncology, University of Oxford, Oxford OX1 2JD, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Panagiotis","family":"Drymousis","sequence":"additional","affiliation":[{"name":"Department of Surgery, Ealing Hospital, London North West University Healthcare NHS Trust, London HA1 3UJ, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"von Roon","sequence":"additional","affiliation":[{"name":"Department of Surgery, University College London Hospitals NHS Foundation Trust London, London NW1 2BU, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam","family":"Humphries","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, St Mark\u2019s Hospital, London North West University Health Care NHS Trust, London HA1 3UJ, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Goldin","sequence":"additional","affiliation":[{"name":"Department of Surgery and Cancer, Imperial College London, Hammersmith Campus, Du Cane Road, London W12 0HS, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jamshed","family":"Bomanji","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine, University College London Hospitals NHS Foundation Trust London, London NW1 2BU, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sydney","family":"Leaman","sequence":"additional","affiliation":[{"name":"MRC Centre for Neurodevelopmental Disorders, King\u2019s College London, London SE1 8WA, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harpreet","family":"Wasan","sequence":"additional","affiliation":[{"name":"Department of Surgery and Cancer, Imperial College London, Hammersmith Campus, Du Cane Road, London W12 0HS, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4920-4154","authenticated-orcid":false,"given":"Nagy","family":"Habib","sequence":"additional","affiliation":[{"name":"Department of Surgery and Cancer, Imperial College London, Hammersmith Campus, Du Cane Road, London W12 0HS, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6130-2035","authenticated-orcid":false,"given":"Andrea","family":"Frilling","sequence":"additional","affiliation":[{"name":"Department of Surgery and Cancer, Imperial College London, Hammersmith Campus, Du Cane Road, London W12 0HS, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,9,6]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1335","DOI":"10.1001\/jamaoncol.2017.0589","article-title":"Trends in the Incidence, Prevalence, and Survival Outcomes in Patients With Neuroendocrine Tumors in the United States","volume":"3","author":"Dasari","year":"2017","journal-title":"JAMA Oncol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"813","DOI":"10.1002\/(SICI)1097-0142(19970215)79:4<813::AID-CNCR19>3.0.CO;2-2","article-title":"An analysis of 8305 cases of carcinoid tumors","volume":"79","author":"Modlin","year":"1997","journal-title":"Cancer"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"272","DOI":"10.1016\/j.surg.2016.05.055","article-title":"Identification of primary tumors in patients presenting with metastatic gastroenteropancreatic neuroendocrine tumors","volume":"161","author":"Keck","year":"2017","journal-title":"Surgery"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"303","DOI":"10.1007\/s11605-017-3586-8","article-title":"Multifocality in Small Bowel Neuroendocrine Tumors","volume":"22","author":"Gangi","year":"2018","journal-title":"J. Gastrointest. Surg."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1115","DOI":"10.1097\/MPA.0000000000000911","article-title":"Is Multifocality an Indicator of Aggressive Behavior in Small Bowel Neuroendocrine Tumors?","volume":"46","author":"Choi","year":"2017","journal-title":"Pancreas"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"180","DOI":"10.1007\/s11605-015-2953-6","article-title":"Role of Staging in Patients with Small Intestinal Neuroendocrine Tumours","volume":"20","author":"Clift","year":"2016","journal-title":"J. Gastrointest. Surg."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"850","DOI":"10.1097\/SLA.0b013e3181fd37e8","article-title":"The Impact of 68Ga-DOTATOC positron emission tomography\/computed tomography on the multimodal management of patients with neuroendocrine tumors","volume":"252","author":"Frilling","year":"2010","journal-title":"Ann. Surg."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"588","DOI":"10.1200\/JCO.2015.64.0987","article-title":"Prospective study of 68Ga-DOTATATE positron emission tomography\/computed tomography for detecting gastro-entero-pancreatic neuroendocrine tumors and unknown primary sites","volume":"34","author":"Sadowski","year":"2016","journal-title":"J. Clin. Oncol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"134","DOI":"10.1001\/jamasurg.2018.3865","article-title":"Prognostic Role of Lymph Node Positivity and Number of Lymph Nodes Needed for Accurately Staging Small-Bowel Neuroendocrine Tumors","volume":"154","author":"Zaidi","year":"2019","journal-title":"JAMA Surg."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"S742","DOI":"10.1245\/s10434-015-4620-2","article-title":"Surgical Management of Small Bowel Neuroendocrine Tumors: Specific Requirements and Their Impact on Staging and Prognosis","volume":"22","author":"Pasquer","year":"2015","journal-title":"Ann. Surg. Oncol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1419","DOI":"10.1007\/s00268-011-1296-z","article-title":"Long-term results of surgery for small intestinal neuroendocrine tumors at a tertiary referral center","volume":"36","author":"Eriksson","year":"2012","journal-title":"World J. Surg."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"869","DOI":"10.21037\/jgo.2019.05.02","article-title":"Survival trends of metastatic small intestinal neuroendocrine tumor: A population-based analysis of SEER database","volume":"10","author":"Shah","year":"2019","journal-title":"J. Gastrointest. Oncol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"715","DOI":"10.1097\/MPA.0000000000000846","article-title":"The surgical management of small bowel neuroendocrine tumors","volume":"46","author":"Howe","year":"2017","journal-title":"Pancreas"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1007\/s00268-020-05727-4","article-title":"Role of Primary Tumor Resection for Metastatic Small Bowel Neuroendocrine Tumors","volume":"45","author":"Hallet","year":"2021","journal-title":"World J. Surg."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"885","DOI":"10.1677\/ERC-09-0042","article-title":"Midgut neuroendocrine tumours with liver metastases: Results of the UKINETS study","volume":"16","author":"Ahmed","year":"2009","journal-title":"Endocr. Relat. Cancer"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"2319","DOI":"10.1245\/s10434-017-5839-x","article-title":"Management of Neuroendocrine Tumor Liver Metastases: Long-Term Outcomes and Prognostic Factors from a Large Prospective Database","volume":"24","author":"Fairweather","year":"2017","journal-title":"Ann. Surg. Oncol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"537","DOI":"10.1016\/j.hpb.2019.08.011","article-title":"ALPPS in neuroendocrine liver metastases not amenable for conventional resection\u2014Lessons learned from an interim analysis of the International ALPPS Registry","volume":"22","author":"Linecker","year":"2020","journal-title":"HPB"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"4656","DOI":"10.1200\/JCO.2009.22.8510","article-title":"Placebo-controlled, double-blind, prospective, randomized study on the effect of octreotide LAR in the control of tumor growth in patients with metastatic neuroendocrine midgut tumors: A report from the PROMID Study Group","volume":"27","author":"Rinke","year":"2009","journal-title":"J. Clin. Oncol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"224","DOI":"10.1056\/NEJMoa1316158","article-title":"Lanreotide in metastatic enteropancreatic neuroendocrine tumors","volume":"371","author":"Caplin","year":"2014","journal-title":"N. Engl. J. Med."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"514","DOI":"10.1056\/NEJMoa1009290","article-title":"Everolimus for advanced pancreatic neuroendocrine tumors","volume":"364","author":"Yao","year":"2011","journal-title":"N. Engl. J. Med."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1056\/NEJMoa1607427","article-title":"Phase 3 Trial of177Lu-Dotatate for Midgut Neuroendocrine Tumors","volume":"376","author":"Strosberg","year":"2017","journal-title":"N. Engl. J. Med."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"444","DOI":"10.1159\/000503721","article-title":"At the Cutting Edge Neuroendocrine Neoplasms of the Small Bowel and Pancreas","volume":"110","author":"Clift","year":"2020","journal-title":"Neuroendocrinology"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"757","DOI":"10.1007\/s00428-007-0452-1","article-title":"TNM staging of midgut and hindgut (neuro) endocrine tumors: A consensus proposal including a grading system","volume":"451","author":"Rindi","year":"2007","journal-title":"Virchows Arch."},{"key":"ref_24","unstructured":"Lloyd, R.V., Osamura, R.Y., Kloppel, G., Rosai, J., World Health Organization, and International Agency for Research on Cancer (2017). WHO Classification of Tumours of Endocrine Organs, International Agency for Research on Cancer. [4th ed.]."},{"key":"ref_25","unstructured":"Klimstra, D.S. (2019). WHO Classification of Tumours: Digestive System Tumours, International Agency for Research on Cancer. [5th ed.]."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1402","DOI":"10.1007\/s002680010232","article-title":"Method for dissection of mesenteric metastases in mid-gut carcinoid tumors","volume":"24","author":"Ohrvall","year":"2000","journal-title":"World J. Surg."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"351","DOI":"10.1007\/s00534-005-0999-7","article-title":"Nomenclature of hepatic anatomy and resections: A review of the Brisbane 2000 system","volume":"12","author":"Strasberg","year":"2005","journal-title":"J. Hepatobiliary Pancreat. Surg."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1245","DOI":"10.1530\/EC-18-0324","article-title":"Intraoperative carcinoid syndrome during small-bowel neuroendocrine tumour surgery","volume":"7","author":"Bouffard","year":"2018","journal-title":"Endocr. Connect."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"205","DOI":"10.1097\/01.sla.0000133083.54934.ae","article-title":"Classification of surgical complications: A new proposal with evaluation in a cohort of 6336 patients and results of a survey","volume":"240","author":"Dindo","year":"2004","journal-title":"Ann. Surg."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"2166","DOI":"10.7150\/ijms.51740","article-title":"A combination of surgery, theranostics, and liquid biopsy\u2014A personalised oncologic approach to treatment of patients with advanced metastatic neuroendocrine neoplasms","volume":"18","author":"Frilling","year":"2021","journal-title":"Int. J. Med. Sci."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"773","DOI":"10.1016\/j.hpb.2018.12.014","article-title":"Radioembolisation with 90Y microspheres for neuroendocrine liver metastases: An institutional case series, systematic review and meta-analysis","volume":"21","author":"Frilling","year":"2019","journal-title":"HPB"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1773","DOI":"10.1016\/S0959-8049(99)00229-4","article-title":"Measurement of clinical and subclinical tumour response using [18F]- fluorodeoxyglucose and positron emission tomography: Review and 1999 EORTC recommendations","volume":"35","author":"Young","year":"1999","journal-title":"Eur. J. Cancer"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"228","DOI":"10.1016\/j.ejca.2008.10.026","article-title":"New response evaluation criteria in solid tumours: Revised RECIST guideline (version 1.1)","volume":"45","author":"Eisenhauer","year":"2009","journal-title":"Eur. J. Cancer"},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Jakobsen, L.H., Andersson, T.M.L., Biccler, J.L., Poulsen, L., Severinsen, M.T., El-Galaly, T.C., and Bogsted, M. (2020). On estimating the time to statistical cure. BMC Med. Res. Methodol., 20.","DOI":"10.1186\/s12874-020-00946-8"},{"key":"ref_35","first-page":"247","article-title":"Neoadjuvant peptide receptor radionuclide therapy and modified multivisceral transplantation for an advanced small intestinal neuroendocrine neoplasm: An updated case report","volume":"2","author":"Clift","year":"2017","journal-title":"Innov. Surg. Sci."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"4935","DOI":"10.18632\/oncotarget.13632","article-title":"Survival outcomes and surgical intervention of small intestinal neuroendocrine tumors: A population based retrospective study","volume":"8","author":"Wu","year":"2017","journal-title":"Oncotarget"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"1168","DOI":"10.1007\/s00595-012-0408-1","article-title":"Outcome of surgery for ileojejunal neuroendocrine tumors","volume":"43","author":"Habbe","year":"2013","journal-title":"Surg. Today"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"837","DOI":"10.1016\/j.jamcollsurg.2013.12.035","article-title":"A single institution\u2019s experience with surgical cytoreduction of stage IV, well-differentiated, small bowel neuroendocrine tumors","volume":"218","author":"Boudreaux","year":"2014","journal-title":"J. Am. Coll. Surg."},{"key":"ref_39","first-page":"700","article-title":"Carcinoid tumors of the duodenum. A clinicopathologic study of 99 cases","volume":"114","author":"Burke","year":"1990","journal-title":"Arch. Pathol. Lab. Med."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"934","DOI":"10.1002\/cncr.11105","article-title":"A 5-decade analysis of 13,715 carcinoid tumors","volume":"97","author":"Modlin","year":"2003","journal-title":"Cancer"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"163","DOI":"10.1530\/ERC-21-0354","article-title":"Long-term survival of metastatic small intestine neuroendocrine tumors: A meta-analysis","volume":"29","author":"Chidambaram","year":"2022","journal-title":"Endocr. Relat. Cancer"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"1752","DOI":"10.1016\/S1470-2045(21)00572-6","article-title":"177 Lu-Dotatate plus long-acting octreotide versus high-dose long-acting octreotide in patients with midgut neuroendocrine tumours (NETTER-1): Final overall survival and long-term safety results from an open-label, randomised, controlled, phase 3 trial","volume":"22","author":"Strosberg","year":"2021","journal-title":"Lancet Oncol."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"6367","DOI":"10.1038\/s41467-021-26581-5","article-title":"Independent somatic evolution underlies clustered neuroendocrine tumors in the human small intestine","volume":"12","author":"Elias","year":"2021","journal-title":"Nat. Commun."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"168","DOI":"10.1016\/j.surg.2020.03.030","article-title":"Outcomes of cytoreductive operations for peritoneal carcinomatosis with or without liver cytoreduction in patients with small bowel neuroendocrine tumors","volume":"169","author":"Wonn","year":"2021","journal-title":"Surgery"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"128","DOI":"10.1097\/PAS.0000000000000751","article-title":"Mesenteric Tumor Deposits in Midgut Small Intestinal Neuroendocrine Tumors Are a Stronger Indicator Than Lymph Node Metastasis for Liver Metastasis and Poor Prognosis","volume":"41","author":"Fata","year":"2017","journal-title":"Am. J. Surg. Pathol."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"1353","DOI":"10.1007\/s00268-014-2451-0","article-title":"Role of Ki-67 proliferation index in the assessment of patients with neuroendocrine neoplasias regarding the stage of disease","volume":"38","author":"Miller","year":"2014","journal-title":"World J. Surg."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"255","DOI":"10.1159\/000464292","article-title":"ENETS Consensus Guidelines for the Standards of Care in Neuroendocrine Tumours: Surgery for Small Intestinal and Pancreatic Neuroendocrine Tumours","volume":"105","author":"Partelli","year":"2017","journal-title":"Neuroendocrinology"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"3678","DOI":"10.1007\/s00464-013-2944-1","article-title":"Laparoscopic resection of primary midgut carcinoid tumors","volume":"27","author":"Reissman","year":"2013","journal-title":"Surg. Endosc."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"1720","DOI":"10.1007\/s00464-013-3381-x","article-title":"Surgery for small-bowel neuroendocrine tumors: Is there any benefit of the laparoscopic approach?","volume":"28","author":"Figueiredo","year":"2014","journal-title":"Surg. Endosc."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"1240","DOI":"10.1097\/DCR.0000000000001915","article-title":"Value of Laparoscopy for Resection of Small-Bowel Neuroendocrine Neoplasms Including Central Mesenteric Lymphadenectomy","volume":"64","author":"Koppes","year":"2021","journal-title":"Dis. Colon. Rectum."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"204","DOI":"10.1002\/jso.25930","article-title":"A novel stratification of mesenteric mass involvement as a predictor of challenging mesenteric lymph node dissection by minimally invasive approach for ileal neuroendocrine tumors","volume":"122","author":"Kasai","year":"2020","journal-title":"J. Surg. Oncol."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"2482","DOI":"10.1007\/s00268-021-06119-y","article-title":"Update on Incidence, Prevalence, Treatment and Survival of Patients with Small Bowel Neuroendocrine Neoplasms in the Netherlands","volume":"45","author":"Sarasqueta","year":"2021","journal-title":"World J. Surg."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"804","DOI":"10.1245\/s10434-016-5574-8","article-title":"Lymphadenectomy during Small Bowel Neuroendocrine Tumor Surgery: The Concept of Skip Metastases","volume":"23","author":"Pasquer","year":"2016","journal-title":"Ann. Surg. Oncol."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"552","DOI":"10.1159\/000441423","article-title":"Toward a preoperative classification of lymph node metastases in patients with small intestinal neuroendocrine tumors in the era of intestinal-sparing surgery","volume":"103","author":"Vullierme","year":"2016","journal-title":"Neuroendocrinology"},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1007\/s11605-017-3524-9","article-title":"Optimal Lymphadenectomy in Small Bowel Neuroendocrine Tumors: Analysis of the NCDB","volume":"22","author":"Motz","year":"2018","journal-title":"J. Gastrointest. Surg."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"197","DOI":"10.1007\/s00268-020-05710-z","article-title":"Extent of Lymph Node Dissection for Small Bowel Neuroendocrine Tumors","volume":"45","author":"Hallet","year":"2021","journal-title":"World J. Surg."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"e13117","DOI":"10.1111\/jne.13117","article-title":"Concept of reintervention with thorough lymphadenectomy after suboptimal resection of small-intestine neuroendocrine neoplasms: A multicentre preliminary study","volume":"34","author":"Deguelte","year":"2022","journal-title":"J. Neuroendocrinol."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"e131","DOI":"10.1016\/j.suronc.2012.05.001","article-title":"Surgical resection of hepatic metastases from neuroendocrine neoplasms: A systematic review","volume":"21","author":"Saxena","year":"2012","journal-title":"Surg. Oncol."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"175","DOI":"10.1002\/bjs.6468","article-title":"Treatment of liver metastases from neuroendocrine tumours in relation to the extent of hepatic disease","volume":"96","author":"Frilling","year":"2009","journal-title":"Br. J. Surg."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"6273847","DOI":"10.1155\/2018\/6273947","article-title":"Resection of Liver Metastases: A Treatment Provides a Long-Term Survival Benefit for Patients with Advanced Pancreatic Neuroendocrine Tumors: A Systematic Review and Meta-Analysis","volume":"2018","author":"Yu","year":"2018","journal-title":"J. Oncol."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"2377","DOI":"10.1007\/s00268-020-05467-5","article-title":"Outcomes of Simultaneous Resection of Small Bowel Neuroendocrine Tumors with Synchronous Liver Metastases","volume":"44","author":"Addeo","year":"2020","journal-title":"World J. Surg."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"298","DOI":"10.1002\/jso.24670","article-title":"Management and outcomes of patients with recurrent neuroendocrine liver metastasis after curative surgery: An international multi-institutional analysis","volume":"116","author":"Spolverato","year":"2017","journal-title":"J. Surg. Oncol."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"3129","DOI":"10.1245\/s10434-010-1154-5","article-title":"Surgical management of hepatic neuroendocrine tumor metastasis: Results from an international multi-institutional analysis","volume":"17","author":"Mayo","year":"2010","journal-title":"Ann. Surg. Oncol."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"977","DOI":"10.1677\/ERC-08-0247","article-title":"Clinical and imaging follow-up after exhaustive liver resection of endocrine metastases: A 15-year monocentric experience","volume":"16","author":"Scigliano","year":"2009","journal-title":"Endocr. Relat. Cancer"},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"427","DOI":"10.1111\/j.1477-2574.2010.00198.x","article-title":"Long-term survival after surgical management of neuroendocrine hepatic metastases","volume":"12","author":"Glazer","year":"2010","journal-title":"HPB"},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"1369","DOI":"10.1016\/j.surg.2014.08.009","article-title":"Expanded criteria for carcinoid liver debulking: Maintaining survival and increasing the number of eligible patients","volume":"156","author":"Sauer","year":"2014","journal-title":"Surgery"},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1016\/S1072-7515(03)00230-8","article-title":"Surgical treatment of neuroendocrine metastases to the liver: A plea for resection to increase survival","volume":"197","author":"Sarmiento","year":"2003","journal-title":"J. Am. Coll. Surg."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"320","DOI":"10.1016\/j.surg.2015.05.040","article-title":"Liver-directed surgery of neuroendocrine metastases: What is the optimal strategy?","volume":"159","author":"Maxwell","year":"2016","journal-title":"Surgery"},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"166","DOI":"10.1016\/j.surg.2018.04.070","article-title":"Effective cytoreduction can be achieved in patients with numerous neuroendocrine tumor liver metastases (NETLMs)","volume":"165","author":"Scott","year":"2019","journal-title":"Surgery"},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"191","DOI":"10.1093\/bjs\/znab413","article-title":"Effect of primary tumour resection without curative intent in patients with metastatic neuroendocrine tumours of the small intestine and right colon: Meta-analysis","volume":"109","author":"Chidambaram","year":"2022","journal-title":"Br. J. Surg."},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"e450","DOI":"10.1097\/SLA.0000000000004647","article-title":"Upfront Small Bowel Resection for Small Bowel Neuroendocrine Tumors with Synchronous Metastases: A Propensity-Score Matched Comparative Population-Based Analysis","volume":"276","author":"Bennett","year":"2020","journal-title":"Ann. Surg."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"183","DOI":"10.1001\/jamaoncol.2017.3326","article-title":"Association of a Prophylactic Surgical Approach to Stage IV Small Intestinal Neuroendocrine Tumors With Survival","volume":"4","author":"Daskalakis","year":"2018","journal-title":"JAMA Oncol."},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"e45","DOI":"10.1097\/SLA.0000000000003237","article-title":"Prior Resection of the Primary Tumor Prolongs Survival After Peptide Receptor Radionuclide Therapy of Advanced Neuroendocrine Neoplasms","volume":"274","author":"Kaemmerer","year":"2021","journal-title":"Ann. Surg."},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"761","DOI":"10.1016\/j.surg.2017.11.007","article-title":"Peptide receptor radionuclide therapy as neoadjuvant therapy for resectable or potentially resectable pancreatic neuroendocrine neoplasms","volume":"163","author":"Partelli","year":"2018","journal-title":"Surgery"},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"1558","DOI":"10.2967\/jnumed.120.258772","article-title":"Surgical Feasibility, Determinants, and Overall Efficacy of Neoadjuvant 177 Lu-DOTATATE PRRT for Locally Advanced Unresectable Gastroenteropancreatic Neuroendocrine Tumors","volume":"62","author":"Parghane","year":"2021","journal-title":"J. Nucl. Med."},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"1530","DOI":"10.1007\/s11605-019-04309-7","article-title":"Management of Ileal Neuroendocrine Tumors with Liver Metastases","volume":"24","author":"Fisher","year":"2020","journal-title":"J. Gastrointest. Surg."},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"250","DOI":"10.1158\/1078-0432.CCR-15-0373","article-title":"Prognostic Impact of Novel Molecular Subtypes of Small Intestinal Neuroendocrine Tumor","volume":"22","author":"Karpathakis","year":"2016","journal-title":"Clin. Cancer Res."},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1016\/j.ando.2019.04.010","article-title":"The landscape of molecular alterations in pancreatic and small intestinal neuroendocrine tumours","volume":"80","author":"Scarpa","year":"2019","journal-title":"Ann. Endocrinol."},{"key":"ref_79","doi-asserted-by":"crossref","unstructured":"Kidd, M., Modlin, I.M., and Drozdov, I. (2014). Gene network-based analysis identifies two potential subtypes of small intestinal neuroendocrine tumors. 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