ENETS Center of Excellence (ENETS CoE) for Neuroendocrine Tumors (NETs)
In 11/2009, the Dept. of Hepatology and Gastroenterology, CCM/CVK, was certified by the European Society for Neuroendocrine Tumors (ENETS) as the first Center of Excellence (CoE) for Neuroendocrine Tumor Diseases in Europe. The basis for the certification process is a close cooperation within of a network between the Clinics for Hepatology and Gastroenterology, Surgery, Diagnostic Radiology and Nuclear Medicine and the Institute for Pathology.
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Certification criteria
• An annual minimum number of the GEP-NET patients
• The team of specialists working at the Center has an extensive experience - at least five (5) years - in diagnostics and therapeutics of GEP-NETs
• Multidisciplinary patient care
• Short waiting times for diagnostic appointments and/or before the start of therapy
• Compliance with high medical quality standards through standardized workflows (standard operating procedures, SOP) as well as internal and external quality controls
• Regular meetings of specialists to improve collaboration within the clinic and establishment of integrated further training
• Ensuring close follow-up care for patients in follow-up care and follow-up, which, depending on the planned examination effort, can be carried out at our center either inpatient or outpatient
• Conducting clinical trials to improve therapy. You can find an overview of the most recent clinical trials carried out in our department on our homepage (link to be included)
Diagnostics
An important requirement for a personalized and disease-adequate treatment of the patient is a detailed diagnosis at the beginning. In order to provide our multidisciplinary tumor board conferences with the best possible basis for evaluation of the extent of the disease, we have an wide range of diagnostic procedures. Because only an adequate and thoroughly diagnostics ultimately leads to an optimal choice of the therapeutic method.
Diagnostics:
- Ultrasound (sonography)
- Gastroscopy and colonoscopy (esophagoduodenoscopy and ileocoloscopy), possibly combined with an ultrasound from inside (endosonography)
- Endoscopic assessment of the entire small intestine using ultrasound (sonography)
- Computer tomography (CT) with or without contrast medium
- Magnetic resonance imaging (MRI), if necessary, with a special contrast medium for the liver
- Somatostatin receptor scintigraphy with radioactively labeled somatostatin analogue (111-Indium Octreotide)
- 68-Gallium DOTATOC Positron Emission Tomography (PET) in combination with a conventional CT (PET/CT)
- PET/CT with radioactively labeled glucose (FDG PET/CT)
- 18F-DOPA-PET/CT
- Ultrasound (echocardiography) and ECG of the heart and
- Other procedures depending on the clinical question
Therapy
Following the diagnosis, the therapeutic procedure is of course also determined and carried out within the framework of the interdisciplinary tumor confrence,, whereby all therapeutic options offered are carried out taking into account the latest scientific findings. Here, in addition to the new therapeutic agents to be investigated in studies, a wide range of already established therapeutic options can be used.
Our therapy offer includes:
- Initiation and regular continuation of somatostatin analogue therapy (octreotide LAR, lanreotide Autogel)
- Implementation of various chemotherapy regimens
- Local ablative and loco-regional procedures: TAE (transarterial embolization), TACE (transarterial chemoembolization), RFA (radiofrequency ablation).
- Nuclear medicine procedures: PRRT with 90Yttrium labeled somatostatin analog or 177Lutetium labeled somatostinalogon.
- Selective intra-arterial radiotherapy (SIRT)
- Nutritional counseling
- Coordination and assistance with outpatient care