Therapeutic strategies for gastroenteropancreatic neuroendocrine neoplasms: State-of-the-art and future perspectives

Table 1 Proposed endoscopic management for gastrointestinal neuroendocrine tumors

	r-NETs	g-NETs	d-NETs	e-NETs
Prevalence (% of GI-NETs)	8-30	4.6-7	1-3	0.2
Indications to EUS	≥ 10 mm	(1) Type I ≥ 10 mm; and (2) Type II-III	Always	Always
Indications to endoscopic resection	< 20 mm, no signs of deep invasion or lymphadenopathy	G1/G2, 10-20 mm, no signs of deep invasion or lymphadenopathy	(1) < 10 mm, no signs of deep invasion or lymphadenopathy; (2) 10-20 mm, G1/G2, no signs of deep invasion or lymphadenopathy (debated); and (3) Periampullary region: G1, no signs of deep invasion or lymphadenopathy(debated)	≤ 10 mm, confined to submucosa, no ulceration
Resection techniques	(1) EMR-C, EMR-L (< 10 mm); and (2) ESD (10-20 mm)	(1) EMR-C, EMR-L (Type I < 10 mm); and (2) ESD (Type I 10-20 mm, Type II-III)	(1) EMR, EMR-C, EMR-L, ESD; and (2) Endoscopic papillectomy in referral centers	EMR-C, EMR-L, ESD

d-NETS: Duodenal neuroendocrine tumors; EMR-C: Cap-assisted endoscopic mucosal resection; EMR-L: Band-ligation endoscopic mucosal resection; e-NETs: Esophageal neuroendocrine tumors; ESD: Endoscopic submucosal dissection; EUS: Endoscopic ultrasound; GI: Gastrointestinal; g-NETs: Gastric neuroendocrine tumors; r-NETs: Rectal neuroendocrine tumors.