Carcinoid of small intestine
ICD-10 D37.2 · ICD-11 2B80.21

Treatment of Localised Resectable Small Intestine Neuroendocrine Tumour

Clinical Scenario
Localised, resectable small intestine neuroendocrine tumour (Si-NET). Surgery is the only opportunity for long-term cure in this setting, given the high rate of lymph node involvement even in smaller tumours. This applies equally to incidentally discovered, asymptomatic lesions.
Treatment Approach
Management centres on surgical resection using organ-sparing techniques performed in a high-volume centre. The operative strategy involves specific intraoperative assessment and a defined approach to lymph node clearance. The protocol specifies the extent of resection and addresses whether adjuvant therapy has a role after curative surgery. Full regimen details, sequencing, and criteria available below →
Instant Access to Structured Evidence-Based Regimens

References

DOI: 10.1111/jne.13423

  • All localised, resectable Si-NET should be operated, since this is the only chance for long-term cure given the high rate of lymph node metastases even in tumours <10 mm.
  • In those rare cases of asymptomatic localised Si-NET that are incidentally discovered, surgery is always the treatment of choice.
  • All localised, resectable Si-NET should be operated on using organ-sparing techniques in high-volume centres (RECOMMENDATION-A-2b).
  • The surgical gold standard includes an open approach with bimanual palpation of the entire small intestine and a vessel-sparing lymphadenectomy (at least >8 lymph nodes) aiming to limit the extent of small intestine resection (RECOMMENDATION A-2b).
  • Adjuvant therapy following curative resection for Si-NET is not indicated.
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