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3. The global leadership into malnutrition criteria reveals a high percentage of malnutrition which influences overall survival in patients with gastroenteropancreatic neuroendocrine tumours.

Author

Clement, Dominique S. V. M., van Leerdam, Monique E., Tesselaar, Margot E. T., Cananea, Elmie, Martin, Wendy, Weickert, Martin O., Sarker, Debashis, Ramage, John K., and Srirajaskanthan, Rajaventhan

Subjects
NEUROENDOCRINE tumors, OVERALL survival, MALNUTRITION, BODY mass index, BODY composition
Abstract

Patients with neuroendocrine tumours located in the gastroenteropancreatic tract (GEP‐NETs) and treatment with somatostatin analogues (SSA's) are at risk of malnutrition which has been reported previously evaluating weight loss or body mass index (BMI) only. The global leadership into malnutrition (GLIM) criteria include weight loss, BMI, and sarcopenia, for diagnosing malnutrition. These GLIM criteria have not been assessed in patients with GEP‐NETs on SSA. The effect of malnutrition on overall survival has not been explored before. The aim of this study is to describe the presence of malnutrition in patients with GEP‐NET on SSA based on the GLIM criteria and associate this with overall survival. Cross‐sectional study screening all patients with GEP‐NETs on SSA's for malnutrition using the GLIM criteria. Body composition analysis for sarcopenia diagnosis were performed. Bloods including vitamins, minerals, and lipid profile were collected. Overall survival since the date of nutrition screening was calculated. Uni‐ and multivariate Cox regression analysis were performed to identify malnutrition as risk factor for overall survival. A total of 118 patients, 47% male, with median age 67 years (IQR 56.8–75.0) were included. Overall, malnutrition was present in 88 patients (75%); based on low BMI in 26 (22%) patients, based on weight loss in 35 (30%) patients, and based on sarcopenia in 83 (70%) patients. Vitamin deficiencies were present for vitamin D in 64 patients (54%), and vitamin A in 29 patients (25%). The presence of malnutrition demonstrated a significantly worse overall survival (p‐value =.01). In multivariate analysis meeting 2 or 3 GLIM criteria was significantly associated with worse overall survival (HR 2.16 95% CI 1.34–3.48, p‐value =.002). Weight loss was the most important risk factor out of the 3 GLIM criteria (HR 3.5 95% CI 1.14–10.85, p‐value =.03) for worse overall survival. A high percentage (75%) of patients with GEP‐NETs using a SSA meet the GLIM criteria for malnutrition. Meeting more than 1 GLIM criterium, especially if there is weight loss these are risk factors for worse overall survival. [ABSTRACT FROM AUTHOR]

Published
2024
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4. Tumour Staging: Ileum

Author

Akbar, Tahir, Srirajaskanthan, Rajaventhan, Ramage, John K., Colao, Annamaria, editor, Faggiano, Antongiulio, editor, and de Herder, Wouter, editor

Published
2018
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17. Neuroendocrine Tumors of the Jejunum and Ileum

Author

Woltering, Eugene A., primary, Bergsland, Emily K., additional, Beyer, David T., additional, O’Dorisio, Thomas M., additional, Rindi, Guido, additional, Klimstra, David S., additional, Tang, Laura H., additional, Reidy-Lagunes, Diane, additional, Strosberg, Jonathan R., additional, Wolin, Edward M., additional, Vinik, Aaron I., additional, Nakakura, Eric K., additional, Asare, Elliot A., additional, Bushnell, David L., additional, Schilsky, Richard L., additional, Wang, Yi-Zarn, additional, Kim, Michelle K., additional, Liu, Eric H., additional, Jensen, Robert T., additional, Wong, Rebecca K. S., additional, Ramage, John K., additional, Mallin, Kathy, additional, and Pommier, Rodney F., additional

Published
2016
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18. Neuroendocrine Tumors of the Appendix

Author

Woltering, Eugene A., primary, Bergsland, Emily K., additional, Beyer, David T., additional, O’Dorisio, Thomas M., additional, Rindi, Guido, additional, Klimstra, David S., additional, Tang, Laura H., additional, Reidy-Lagunes, Diane, additional, Strosberg, Jonathan R., additional, Wolin, Edward M., additional, Vinik, Aaron I., additional, Nakakura, Eric K., additional, Asare, Elliot A., additional, Bushnell, David L., additional, Schilsky, Richard L., additional, Wang, Yi-Zarn, additional, Kim, Michelle K., additional, Liu, Eric H., additional, Jensen, Robert T., additional, Wong, Rebecca K. S., additional, Ramage, John K., additional, and Pommier, Rodney F., additional

Published
2016
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19. Neuroendocrine Tumors of the Stomach

Author

Woltering, Eugene A., primary, Bergsland, Emily K., additional, Beyer, David T., additional, O’Dorisio, Thomas M., additional, Rindi, Guido, additional, Klimstra, David S., additional, Tang, Laura H., additional, Reidy-Lagunes, Diane, additional, Strosberg, Jonathan R., additional, Wolin, Edward M., additional, Vinik, Aaron I., additional, Nakakura, Eric K., additional, Asare, Elliot A., additional, Bushnell, David L., additional, Schilsky, Richard L., additional, Wang, Yi-Zarn, additional, Kim, Michelle K., additional, Liu, Eric H., additional, Jensen, Robert T., additional, Wong, Rebecca K. S., additional, Ramage, John K., additional, and Pommier, Rodney F., additional

Published
2016
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21. Incidence, prevalence of survival of neuroendocrine neoplasia in England 1995-2018

Author

Kandiah Chandrakumaran, White Benjamin Easton, Brian Rous, Ramage John K, Hemelrijck Mieke van, Catherine Bouvier, Kwok Wong, and Rajaventhan Srirajaskanthan

Subjects
Neuroendocrine neoplasia, Oncology, medicine.medical_specialty, business.industry, Internal medicine, Medicine, business, Incidence prevalence
Published
2021

22. Nodal metastases in small rectal neuroendocrine tumours

Author

O’Neill, Sarah, primary, Haji, Amyn, additional, Ryan, Suzanne, additional, Clement, Dominique, additional, Sarras, Konstantinos, additional, Hayee, Bu, additional, Mulholland, Nicola, additional, Ramage, John K., additional, and Srirajaskanthan, Rajaventhan, additional

Published
2021
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24. Colorectal Neuroendocrine Neoplasms

Author

Ramage, John K., Valle, Juan W., van Dijkum, Els J. M. Nieveen, Sundin, Anders, Pascher, Andreas, Couvelard, Anne, Kloeppel, Guenter, Bartsch, Detlef, Arnold, Rudolf, Baudin, Eric, Bodei, Lisa, Borbath, Iva, Capdevila, Jaume, Caplin, Matyn, Chen, Jie, Costa, Frederico, Cwikla, Jaroslaw B., Davies, Philippa, de Herder, Wouter W., Falconi, Massimo, Falkerby, Jenny, Fazio, Nicola, Ferone, Diego, Frilling, Andrea, Garcia-Carbonero, Rocio, Glasberg, Simona, Gorbunova, Vera, Grossman, Ashley, Hoersch, Dieter, Jensen, Robert, Kaltsas, Gregory, Kingge, Ulrich Peter, Kos-Kudla, Beata, Krejs, Guenter J., Krenning, Eric, Kulke, Matthew, Lamberts, Steven W. J., Van Dijkum, Nieveen Els J. M., O'Connor, Juan Manuel, O'Toole, Dermot, Pape, Ulrich-Frank, Partelli, Stefano, Pavel, Marianne Ellen, Peeters, Marc, Reed, Nicholas Simon, Rindi, Guido, Rinke, Anja, Ruszniewski, Philippe, Sorbye, Halfdan, Scoazec, Jean-Yves, Taal, Babs G., Janson, Tiensuu Eva, Toumpanakis, Christos, Vullierme, Marie-Pierre, Staffan, Welin, Wiedenmann, Bertman, ENETS 2016 Munich Advisory Board, Ramage, Jk, Valle, Jw, Nieveen, Van Dijkum EJM, Sundin, A, Pascher, A, Couvelard, A, Kloeppel, G, on behalf of The ENETS 2016 MunichAdvisory Board, Partecipant, Partelli, S, Falconi, M, Internal Medicine, and Radiology & Nuclear Medicine

Subjects
Gastroenteropancreatic neuroendocrine tumour, Oncology, medicine.medical_specialty, Biomedical Research, Colorectal cancer, Endocrinology, Diabetes and Metabolism, Carcinoid tumour, Improved survival, 030209 endocrinology & metabolism, World health, Somatostatin receptor, 030218 nuclear medicine & medical imaging, Unmet needs, 03 medical and health sciences, Cellular and Molecular Neuroscience, Biomedical Research/trends, 0302 clinical medicine, Endocrinology, Internal medicine, Neuroendocrine tumour, Epidemiology, medicine, Colorectal Neoplasms/classification, Humans, Stage (cooking), Endocrine and Autonomic Systems, business.industry, Poorly differentiated, medicine.disease, digestive system diseases, Neuroendocrine Tumors, Neuroendocrine Tumors/classification, Human medicine, business, Colorectal Neoplasms
Abstract

The subject of colorectal neuroendocrine neoplasms (NENs), subdivided into well-differentiated NENs, termed neuroendocrine tumours (NETs; grade (G) 1 and 2), and poorly differentiated NENs, termed neuroendocrine carcinomas (NECs; G3) according to the 2010 World Health Organisation (WHO) classification, has arguably not had as much attention or study as NENs occurring in other sites. Colorectal NETs and NECs are however easier to study than many others since they are usually not difficult to remove and are increasingly detected because of intensified colorectal cancer screening and surveillance programmes. Colorectal NETs and NECs show site-specific heterogeneity with variable behaviour and different therapeutic options; these various aspects provide unique challenges. Because of bowel cancer screening programmes, colorectal NENs, like conventional adenocarcinomas, may be diagnosed at a stage that is associated with improved survival. In this article we intend to describe and define areas of unmet needs relating to the epidemiology, classification, pathology, diagnosis and therapy of colorectal NETs (including NETs G3), colorectal NECs, and finally, mixed adeno-neuroendocrine carcinomas (MANECs) by reviewing and discussing the relevant literature.

Published
2019

26. Colorectal Neuroendocrine Neoplasms: Areas of Unmet Need

Author

Ramage, John K. Valle, Juan W. van Dijkum, Els J. M. Nieveen and Sundin, Anders Pascher, Andreas Couvelard, Anne Kloeppel, Guenter Bartsch, Detlef Arnold, Rudolf Baudin, Eric and Bodei, Lisa Borbath, Iva Capdevila, Jaume Caplin, Matyn and Chen, Jie Costa, Frederico Couvelard, Anne Cwikla, Jaroslaw B. Davies, Philippa de Herder, Wouter W. Falconi, Massimo and Falkerby, Jenny Fazio, Nicola Ferone, Diego Frilling, Andrea Garcia-Carbonero, Rocio Glasberg, Simona Gorbunova, Vera Grossman, Ashley Hoersch, Dieter Jensen, Robert and Kaltsas, Gregory Kloeppel, Guenter Kingge, Ulrich Peter and Kos-Kudla, Beata Krejs, Guenter J. Krenning, Eric Kulke, Matthew Lamberts, Steven W. J. Van Dijkum, Nieveen Els J. M. and O'Connor, Juan Manuel O'Toole, Dermot Pape, Ulrich-Frank and Partelli, Stefano Pavel, Marianne Ellen Peeters, Marc and Ramage, John K. Reed, Nicholas Simon Rindi, Guido Rinke, Anja Ruszniewski, Philippe Sorbye, Halfdan Sundin, Anders and Scoazec, Jean-Yves Taal, Babs G. Janson, Tiensuu Eva and Toumpanakis, Christos Valle, Juan W. Vullierme, Marie-Pierre and Staffan, Welin Wiedenmann, Bertman ENETS 2016 Munich Advisory Board

Subjects
digestive system diseases
Abstract

The subject of colorectal neuroendocrine neoplasms (NENs), subdivided into well-differentiated NENs, termed neuroendocrine tumours (NETs; grade (G) 1 and 2), and poorly differentiated NENs, termed neuroendocrine carcinomas (NECs; G3) according to the 2010 World Health Organisation (WHO) classification, has arguably not had as much attention or study as NENs occurring in other sites. Colorectal NETs and NECs are however easier to study than many others since they are usually not difficult to remove and are increasingly detected because of intensified colorectal cancer screening and surveillance programmes. Colorectal NETs and NECs show site-specific heterogeneity with variable behaviour and different therapeutic options; these various aspects provide unique challenges. Because of bowel cancer screening programmes, colorectal NENs, like conventional adenocarcinomas, may be diagnosed at a stage that is associated with improved survival. In this article we intend to describe and define areas of unmet needs relating to the epidemiology, classification, pathology, diagnosis and therapy of colorectal NETs (including NETs G3), colorectal NECs, and finally, mixed adeno-neuroendocrine carcinomas (MANECs) by reviewing and discussing the relevant literature.

Published
2019

27. Development of a quality of life questionnaire for patients with pancreatic neuroendocrine tumours (the PANNET module).

Author

Ramage, John K., Friend, Elizabeth, Randell, Jordan, KING, Barbara, Fernandez Ortega, Paz, McNamara, Mairéad G., Kaltsas, Gregory, Falconi, Massimo, Cwikla, Jaroslav, Capdevila, Jaume, Grozinsky‐Glasberg, Simona, Mandair, Dalvinder, Gamper, Eva, Srirajaskanthan, Raj, O Weickert, Martin, and Gray, Debra

Subjects
*NEUROENDOCRINE tumors, *MEDICAL personnel, *QUALITY of life, *INSULINOMA, *SOMATOTROPIN
Abstract

Pancreatic neuroendocrine tumours (panNET) are heterogeneous neoplasms usually characterised by slow growth and secretion of hormones, which often cause symptoms. The effect of these symptoms on quality of life (QoL) has not previously been examined in detail. EORTC (European Organisation for Research and Treatment of Cancer) guidelines were followed in phases 1–3 to produce a potential module of questions usable for trials in panNET, focusing on three common types of panNET. For two less common types, a list of symptoms was constructed. Following an extensive literature search and phase 1a interviews with patients and healthcare workers, a long list of potential issues (169) was obtained. This list was shown to 12 patients from three countries in phase 1b interviews to check that no items were missed. The list was reduced to 57 issues. The list of issues was converted to questions, mainly from existing validated questions within the EORTC item library. The list of questions was then used in a phase 3 international study in eight countries using seven languages. A provisional module of 24 items is presented for use in nonfunctioning panNET, gastrinoma and insulinoma. This module increases knowledge concerning QoL in this condition and may be a useful adjunct in clinical trials. A phase 4 trial is being considered for validation of this questionnaire. [ABSTRACT FROM AUTHOR]

Published
2022
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29. Management of Asymptomatic Sporadic Nonfunctioning Pancreatic Neuroendocrine Neoplasms (ASPEN) ≤2 cm: Study Protocol for a Prospective Observational Study

Author

Partelli, Stefano, primary, Ramage, John K., additional, Massironi, Sara, additional, Zerbi, Alessandro, additional, Kim, Hong Beom, additional, Niccoli, Patricia, additional, Panzuto, Francesco, additional, Landoni, Luca, additional, Tomazic, Ales, additional, Ibrahim, Toni, additional, Kaltsas, Gregory, additional, Bertani, Emilio, additional, Sauvanet, Alain, additional, Segelov, Eva, additional, Caplin, Martyn, additional, Coppa, Jorgelina, additional, Armstrong, Thomas, additional, Weickert, Martin O., additional, Butturini, Giovanni, additional, Staettner, Stefan, additional, Boesch, Florian, additional, Cives, Mauro, additional, Moulton, Carol Anne, additional, He, Jin, additional, Selberherr, Andreas, additional, Twito, Orit, additional, Castaldi, Antonio, additional, De Angelis, Claudio Giovanni, additional, Gaujoux, Sebastien, additional, Almeamar, Hussein, additional, Frilling, Andrea, additional, Vigia, Emanuel, additional, Wilson, Colin, additional, Muffatti, Francesca, additional, Srirajaskanthan, Raj, additional, Invernizzi, Pietro, additional, Lania, Andrea, additional, Kwon, Wooil, additional, Ewald, Jacques, additional, Rinzivillo, Maria, additional, Nessi, Chiara, additional, Smid, Lojze M., additional, Gardini, Andrea, additional, Tsoli, Marina, additional, Picardi, Edgardo E., additional, Hentic, Olivia, additional, Croagh, Daniel, additional, Toumpanakis, Christos, additional, Citterio, Davide, additional, Ramsey, Emma, additional, Mosterman, Barbara, additional, Regi, Paolo, additional, Gasteiger, Silvia, additional, Rossi, Roberta E., additional, Smiroldo, Valeria, additional, Jang, Jin-Young, additional, and Falconi, Massimo, additional

Published
2020
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34. Development of ex-vivo models of metastatic neuroendocrine neoplasms

Author

Doornebal, Ewald, primary, Harris, Nicola, additional, Edwards, Helen, additional, Miquel, Rosa, additional, Zen, Yoh, additional, Pizanias, Michail, additional, Prachalias, Andreas, additional, Menon, Krishna, additional, Zamalloa, Ane, additional, Preziosi, Melissa, additional, Heaton, Nigel, additional, Ramage, John K, additional, Williams, Roger, additional, Palma, Elena, additional, Chokshi, Shilpa, additional, and Srirajaskanthan, Raj, additional

Published
2019
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36. Nodal metastases in small rectal neuroendocrine tumours.

Author

O'Neill, Sarah, Haji, Amyn, Ryan, Suzanne, Clement, Dominique, Sarras, Konstantinos, Hayee, Bu, Mulholland, Nicola, Ramage, John K., and Srirajaskanthan, Rajaventhan

Subjects
NEUROENDOCRINE tumors, RECTAL cancer, POSITRON emission tomography, CROSS-sectional imaging, LYMPHATIC metastasis, METASTASIS
Abstract

Aim: Rectal neuroendocrine tumours (NETs) are the most common type of gastrointestinal NET. European Neuroendocrine Tumour Society guidelines suggest that rectal NETs measuring ≤10 mm are indolent with low risk of spread. In practice, many patients with lesions ≤1 cm do not undergo complete tumour staging. However, the size of the lesion may not be the only risk factor for nodal involvement/metastases. The aim of this study was to determine if MRI ± nuclear medicine imaging alters tumour stage in patients with rectal NETs ≤10 mm. Methods: Patients referred to a tertiary NET centre between 2005 and 2020 who met the inclusion criteria of a rectal NET ≤10 mm, full cross‐sectional imaging, primarily an MRI scan and, if abnormal findings were identified, a subsequent 68Ga‐DOTATATE positron emission tomography scan were included. All patients were followed up at our institution. Results: In all, 32 patients with rectal NETs 10 mm or less were included in the study: 16 women; median age 58 years (range 33–71); 47% (n = 15) were referred from bowel cancer screening procedures. The median size of the lesions was 5 mm (range 2–10 mm). 81% (n = 26) were World Health Organization Grade 1 tumours with Ki67 <3%. Radiological staging confirmed nodal involvement in 25% (8/32); two cases had distant metastatic disease. Lymphovascular invasion was present in 3% (1/32) of patients but none demonstrated peri‐neural invasion. Conclusion: This study demonstrates that small rectal NETs can develop nodal metastases; therefore it is important to stage these tumours accurately with MRI at baseline and, if there are concerns regarding potential lymph node metastases, to consider 68Ga‐DOTATATE positron emission tomography imaging. [ABSTRACT FROM AUTHOR]

Published
2021
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40. Tumour diameter is not reliable for management of non-secreting pancreatic neuroendocrine tumours

Author

Mills, Logan, primary, Drymousis, Panagiotis, additional, Vashist, Yogesh, additional, Burdelski, Christoph, additional, Prachalias, Andreas, additional, Srinivasan, Parthi, additional, Menon, Krishna, additional, Cotoi, Corina, additional, Khan, Saboor, additional, Cave, Judith, additional, Armstrong, Thomas, additional, Weickert, Martin O, additional, Izbicki, Jakob, additional, Schrader, Joerg, additional, Frilling, Andreja, additional, Ramage, John K, additional, and Srirajaskanthan, Raj, additional

Published
2017
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41. Vindaloo And You [with Reply]

Author

Ramage, John K., Hunt, Richard H., Ayres, Jon G., Bjarnason, Ingvar, Levi, Sassoon, Smethurst, Paul, Menzies, Ian S., and Levi, A. Jonathan

Published
1989

42. Tumour Size is not a Reliable Criterion for Resection of Patients with Non-Secreting Pancreatic Neuroendocrine Tumours: Results of an International, Multi-Centre, Operative Cohort

Author

Mills, Logan, primary, Drymousis, Panagiotis, additional, Vashist, Yogesh, additional, Burdelski, Christoph, additional, Prachalias, Andreas, additional, Srinivasan, Parthi, additional, Menon, Krishna, additional, Khan, Saboor, additional, Cave, Judith, additional, Armstrong, Thomas, additional, Weickert, Martin O., additional, Frilling, Andrea, additional, Ramage, John K., additional, and Srirajaskanthan, Raj, additional

Published
2017
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44. Colorectal Neuroendocrine Neoplasms: Areas of Unmet Need.

Author

Ramage, John K., Valle, Juan W., Nieveen van Dijkum, Els J.M., Sundin, Anders, Pascher, Andreas, Couvelard, Anne, and Kloeppel, Guenter

Subjects
*COLON diseases, *NEUROENDOCRINE tumors, *CARCINOMA, *ADENOCARCINOMA
Abstract

The subject of colorectal neuroendocrine neoplasms (NENs), subdivided into well-differentiated NENs, termed neuroendocrine tumours (NETs; grade (G) 1 and 2), and poorly differentiated NENs, termed neuroendocrine carcinomas (NECs; G3) according to the 2010 World Health Organisation (WHO) classification, has arguably not had as much attention or study as NENs occurring in other sites. Colorectal NETs and NECs are however easier to study than many others since they are usually not difficult to remove and are increasingly detected because of intensified colorectal cancer screening and surveillance programmes. Colorectal NETs and NECs show site-specific heterogeneity with variable behaviour and different therapeutic options; these various aspects provide unique challenges. Because of bowel cancer screening programmes, colorectal NENs, like conventional adenocarcinomas, may be diagnosed at a stage that is associated with improved survival. In this article we intend to describe and define areas of unmet needs relating to the epidemiology, classification, pathology, diagnosis and therapy of colorectal NETs (including NETs G3), colorectal NECs, and finally, mixed adeno-neuroendocrine carcinomas (MANECs) by reviewing and discussing the relevant literature. [ABSTRACT FROM AUTHOR]

Published
2019
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45. How to diagnose and manage hepatic encephalopathy

Author

Shawcross, Debbie L., primary, Dunk, Arthur A., additional, Jalan, Rajiv, additional, Kircheis, Gerald, additional, de Knegt, Robert J., additional, Laleman, Wim, additional, Ramage, John K., additional, Wedemeyer, Heiner, additional, and Morgan, Ian E.J., additional

Published
2016
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47. A Multimodal Approach to the Management of Neuroendocrine Tumour Liver Metastases

Author

Basuroy, Ron, Srirajaskanthan, Rajaventhan, and Ramage, John K.

Subjects
Article Subject
Abstract

Neuroendocrine tumours (NETs) are often indolent malignancies that commonly present with metastatic disease in the liver. Surgical, locoregional, and systemic treatment modalities are reviewed. A multidisciplinary approach to patient care is suggested to ensure all therapeutic options explored.

Published
2012
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49. 1022 - Tumour Size is not a Reliable Criterion for Resection of Patients with Non-Secreting Pancreatic Neuroendocrine Tumours: Results of an International, Multi-Centre, Operative Cohort

Author

Mills, Logan, Drymousis, Panagiotis, Vashist, Yogesh, Burdelski, Christoph, Prachalias, Andreas, Srinivasan, Parthi, Menon, Krishna, Khan, Saboor, Cave, Judith, Armstrong, Thomas, Weickert, Martin O., Frilling, Andrea, Ramage, John K., and Srirajaskanthan, Raj

Published
2017
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50. Guidelines for the management of gastroenteropancreatic neuroendocrine (including carcinoid) tumours (NETs)

Author

Ramage, John K, primary, Ahmed, A, additional, Ardill, J, additional, Bax, N, additional, Breen, D J, additional, Caplin, M E, additional, Corrie, P, additional, Davar, J, additional, Davies, A H, additional, Lewington, V, additional, Meyer, T, additional, Newell-Price, J, additional, Poston, G, additional, Reed, N, additional, Rockall, A, additional, Steward, W, additional, Thakker, R V, additional, Toubanakis, C, additional, Valle, J, additional, Verbeke, C, additional, and Grossman, A B, additional

Published
2011
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