Well-established criteria for evaluating the response to treatment and the appropriate followup
of individual patients are critical in clinical oncology. The current evidence-based data on these
issues in terms of the management of gastroenteropancreatic (GEP) neuroendocrine neoplasms (NEN)
are unfortunately limited.
This document by the Italian Association of Clinical Endocrinologists (AME) on the criteria for the
follow-up of GEP-NEN patients is aimed at providing comprehensive recommendations for everyday
clinical practice based on both the best available evidence and the combined opinion of an interdisciplinary
panel of experts.
The initial risk stratification of patients with NENs should be performed according to the grading, staging
and functional status of the neoplasm and the presence of an inherited syndrome. The evaluation of
response to the initial treatment, and to the subsequent therapies for disease progression or recurrence,
should be based on a cost-effective, risk-effective and timely use of the appropriate diagnostic resources.
A multidisciplinary evaluation of the response to the treatment is strongly recommended and, at every
step in the follow-up, it is mandatory to assess the disease state and the patient performance status,
comorbidities, and recent clinical evolution.
Local expertise, available technical resources and the patient preferences should always be evaluated
while planning the individual clinical management of GEP-NENs.