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@ARTICLE{Schmidt:282724,
      author       = {M. Schmidt and C. Hinterleitner and S. Singer and U. M.
                      Lauer$^*$ and L. Zender$^*$ and M. Hinterleitner},
      title        = {{D}iagnostic {A}pproaches for {N}euroendocrine {N}eoplasms
                      of {U}nknown {P}rimary ({NEN}-{UP}s) and {T}heir
                      {P}rognostic {R}elevance-{A} {R}etrospective, {L}ong-{T}erm
                      {S}ingle-{C}enter {E}xperience.},
      journal      = {Cancers},
      volume       = {15},
      number       = {17},
      issn         = {2072-6694},
      address      = {Basel},
      publisher    = {MDPI},
      reportid     = {DKFZ-2023-01850},
      pages        = {4316},
      year         = {2023},
      abstract     = {Neuroendocrine neoplasms (NENs) represent a rare and
                      heterogenous group of tumors with predominantly
                      gastroenteropancreatic or pulmonary origin. Despite numerous
                      diagnostic efforts, the primary tumor site remains unknown
                      in up to $20\%$ of the patients diagnosed with NEN. In this
                      subgroup of NEN patients, a standard diagnostic algorithm
                      has not yet been integrated into clinical routine. Of note,
                      an undetermined primary tumor site in NENs is associated
                      with an impaired clinical outcome by at least 'formally'
                      limiting treatment options exclusively approved for NENs of
                      a certain histological origin. In this retrospective study,
                      a patient cohort of 113 patients initially diagnosed with
                      NEN of unknown primary (NEN-UP) was analyzed. In 13 patients
                      $(11.5\%)$ a primary tumor site could be identified
                      subsequently, amongst others, by performing somatostatin
                      receptor (SSTR)-PET-based imaging, which was irrespective of
                      the initial clinical or demographic features. Diagnostic
                      work-up and therapeutic regimens did not differ
                      significantly between patients with an identified or
                      unidentified primary tumor site; only a detailed
                      immunohistochemical assessment providing additional
                      information on the tumor origin proved to be significantly
                      associated with the detection of a primary tumor site. Our
                      study revealed that a profound diagnostic work-up,
                      particularly including SSTR-PET-based imaging, leads to
                      additional treatment options, finally resulting in
                      significantly improved clinical outcomes for patients with
                      NEN-UPs.},
      keywords     = {cancer of unknown primary (Other) / diagnosis (Other) /
                      endoscopy (Other) / imaging (Other) / immunohistochemistry
                      (Other) / neuroendocrine neoplasm (Other) / overall survival
                      (Other) / prognosis (Other)},
      cin          = {TU01},
      ddc          = {610},
      cid          = {I:(DE-He78)TU01-20160331},
      pnm          = {899 - ohne Topic (POF4-899)},
      pid          = {G:(DE-HGF)POF4-899},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:37686593},
      pmc          = {pmc:PMC10486951},
      doi          = {10.3390/cancers15174316},
      url          = {https://inrepo02.dkfz.de/record/282724},
}