TY - JOUR
T1 - Consensus Guideline for the Management of Peritoneal Metastases from Neuroendocrine Neoplasms
AU - Peritoneal Surface Malignancies (PSM) Consortium Group
AU - Su, David G.
AU - Brown, Leanne M.
AU - Bansal, Varun V.
AU - Bakkila, Baylee
AU - Concors, Seth J.
AU - Turaga, Kiran K.
AU - Gunderson, Craig
AU - Bergsland, Emily
AU - Strosberg, Jonathan R.
AU - Halfdanarson, Thorvardur R.
AU - Metz, David C.
AU - Kunstman, John W.
AU - Kunz, Pamela L.
AU - Gangi, Alexandra
AU - Gao, Xiang
AU - Keutgen, Xavier
AU - Bowne, Wilbur B.
AU - Luo, Wenyi
AU - Vudatha, Vignesh
AU - Gushchin, Vadim
AU - Khan, Uqba
AU - Sarpel, Umut
AU - Maduekwe, Ugwuji
AU - Grotz, Travis
AU - Hope, Thomas
AU - Lwin, Thinzar
AU - Jaraczewski, Taylor
AU - Gamblin, TClark
AU - Campbell, Susan
AU - Libutti, Steven
AU - Greco, Stephanie
AU - Abdel-Misih, Sherif
AU - Radomski, Shannon
AU - Sherman, Scott
AU - Wilkins, Sarah
AU - Daniel, Sara
AU - Bagaria, Sanjay
AU - Butensky, Samuel
AU - Naffouje, Samer
AU - Patel, Sameer
AU - Ruff, Samantha
AU - Pappas, Sam George
AU - Ganai, Sabha
AU - Merkow, Ryan
AU - Shah, Rupen
AU - Sticca, Robert
AU - Ramirez, Robert
AU - Akumuo, Rita
AU - Kwakman, Riom
AU - Georgakis, Georgios
N1 - Publisher Copyright:
© American Cancer Society 2025.
PY - 2026/6
Y1 - 2026/6
N2 - Background: Neuroendocrine neoplasms (NEN) with peritoneal metastases (PM) represent a complex clinical challenge due to low incidence and heterogeneous phenotypes. This manuscript describes the results of a national consensus aimed at addressing clinical management of patients with NEN-PM. Methods: An update of the 2018 Chicago consensus guidelines was conducted using a modified Delphi technique, encompassing two rounds of voting. The levels of agreement for various pathway blocks were assessed. Key systemic therapy concepts were summarized by content experts. Supporting evidence was evaluated via a rapid literature review. Results: Overall, the level of evidence for the management of PM in this disease was universally low. In total, 107 participants responded in the first round, with 88/107 (82%) participating in the second round. Strong consensus (> 90%) was achieved in 5/7 (71%) and 7/7 (100%) blocks in rounds I and II respectively. A multidisciplinary approach including psychosocial and wellness assessments received a strong positive recommendation. Management of NENs with PM was organized according to disease grade and symptom profiles. In grade 1 and 2 well-differentiated NENs, cytoreductive surgery (CRS) received strong support (>95%) following the management of functional syndromes (if present). For grade 3 well-differentiated NENs, systemic therapy is the primary recommendation, with surgical resection considered in select cases. Conclusion: Given limited evidence, the consensus-driven clinical pathway offers vital clinical guidance for the management on NENs with PM.
AB - Background: Neuroendocrine neoplasms (NEN) with peritoneal metastases (PM) represent a complex clinical challenge due to low incidence and heterogeneous phenotypes. This manuscript describes the results of a national consensus aimed at addressing clinical management of patients with NEN-PM. Methods: An update of the 2018 Chicago consensus guidelines was conducted using a modified Delphi technique, encompassing two rounds of voting. The levels of agreement for various pathway blocks were assessed. Key systemic therapy concepts were summarized by content experts. Supporting evidence was evaluated via a rapid literature review. Results: Overall, the level of evidence for the management of PM in this disease was universally low. In total, 107 participants responded in the first round, with 88/107 (82%) participating in the second round. Strong consensus (> 90%) was achieved in 5/7 (71%) and 7/7 (100%) blocks in rounds I and II respectively. A multidisciplinary approach including psychosocial and wellness assessments received a strong positive recommendation. Management of NENs with PM was organized according to disease grade and symptom profiles. In grade 1 and 2 well-differentiated NENs, cytoreductive surgery (CRS) received strong support (>95%) following the management of functional syndromes (if present). For grade 3 well-differentiated NENs, systemic therapy is the primary recommendation, with surgical resection considered in select cases. Conclusion: Given limited evidence, the consensus-driven clinical pathway offers vital clinical guidance for the management on NENs with PM.
KW - Clinical guidelines
KW - Cytoreductive surgery
KW - Neuroendocrine neoplasms
KW - Peritoneal surface malignancies
KW - Peritoneal surface neoplasms
UR - https://www.scopus.com/pages/publications/105011883212
U2 - 10.1245/s10434-025-17360-3
DO - 10.1245/s10434-025-17360-3
M3 - Article
C2 - 40560496
AN - SCOPUS:105011883212
SN - 1068-9265
VL - 33
SP - 5204
EP - 5221
JO - Annals of Surgical Oncology
JF - Annals of Surgical Oncology
IS - 6
ER -