{
  "abstract": "Purpose: In some situations, the pathological diagnosis of neuroendocrine neoplasms (NEN) remains challenging, with direct consequences for treatment decisions. ENDOCAN-TENpath, the French national expert network for NEN pathology, established monthly virtual \"third-reading\" sessions for collegial review of difficult cases. We evaluated the diagnostic outcomes and clinical impact of this process. Methods: All cases submitted to third-reading sessions from March 2022 to December 2023 were retrospectively reviewed. We analyzed diagnostic difficulties, diagnostic modifications, and their expected therapeutic impact. Results: Of 3239 cases received by ENDOCAN-TENpath, 126 (3.9%) were submitted to third-reading by 22 of 33 network pathologists (median turnaround: 20 days). Diagnostic difficulties fell into four categories: high-grade NEN classification (33.3%), mixed neuroendocrine/non-neuroendocrine neoplasm diagnosis (36.5%), incomplete neuroendocrine phenotypes (23.0%), and unfamiliar entities (7.1%). Consensus or majority diagnosis was reached in 102 cases (81%). Unresolved cases were due to lack of consensus (n = 13) or insufficient material (n = 10). Critically, the process yielded decisions with major therapeutic consequences: 20/46 presumed NENs were reclassified as non-neuroendocrine malignancies and 5/25 presumed adenocarcinomas as NENs, fundamentally altering treatment strategy. Furthermore, 32/42 ambiguous high-grade NENs were definitively classified as tumor or carcinoma, directly determining first-line chemotherapy regimen. These findings also prompted internal guidelines to reduce diagnostic variability. Conclusion: The ENDOCAN-TENpath third-reading process yields a high rate of clinically actionable diagnostic decisions directly altering treatment strategy, while identifying unmet needs and providing a framework for reducing diagnostic variability in complex NEN cases.",
  "abstract_shown": true,
  "affiliations": [],
  "article_type": null,
  "arxiv": null,
  "author_total": 33,
  "authors": [
    {
      "name": "Matthieu Tihy"
    },
    {
      "name": "Jean-Yves Scoazec"
    },
    {
      "name": "Serge Guyétant"
    },
    {
      "name": "Mohamed-Amine Bani"
    },
    {
      "name": "Céline Bazille"
    },
    {
      "name": "Geneviève Belleannée"
    },
    {
      "name": "Christian Boissy"
    },
    {
      "name": "Camille Boulagnon-Rombi"
    },
    {
      "name": "Aurélie Cazes"
    },
    {
      "name": "Aurélie Charissoux"
    },
    {
      "name": "Marie-Pierrette Chenard"
    },
    {
      "name": "Marie Danjoux"
    },
    {
      "name": "Camille Darcha"
    },
    {
      "name": "Laurent Doucet"
    },
    {
      "name": "Charlotte Dufour"
    },
    {
      "name": "Antonin Fattori"
    },
    {
      "name": "Anne Guyot"
    },
    {
      "name": "Valérie Hervieu"
    },
    {
      "name": "Marie-Françoise Heymann"
    },
    {
      "name": "Catherine Julié"
    },
    {
      "name": "Thibault Kervarrec"
    },
    {
      "name": "Cosmin Lazaroiu"
    },
    {
      "name": "Emmanuelle Leteurtre"
    },
    {
      "name": "Laurent Martin"
    },
    {
      "name": "Stéphanie Patouraux"
    },
    {
      "name": "Flora Poizat"
    },
    {
      "name": "Nicolas Poté"
    },
    {
      "name": "Agathe Régnier"
    },
    {
      "name": "Benjamin Rivière"
    },
    {
      "name": "Magali Svrcek"
    },
    {
      "name": "Benoît Terris"
    },
    {
      "name": "Jérôme Cros"
    },
    {
      "name": "Anne Couvelard"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/6jg2ka5c37463.bib",
  "cited_by": 0,
  "doi": "10.1016/j.ejca.2026.117018",
  "fulltext_url": null,
  "id": "6jg2ka5c37463",
  "issns": [
    "0959-8049"
  ],
  "landing_url": "https://hal.science/hal-05752715v1",
  "language": "en",
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "hal",
      "0.sdv"
    ],
    [
      "hal",
      "1.sdv.can"
    ],
    [
      "hal",
      "1.sdv.mhep"
    ],
    [
      "openalex",
      "2713|Neuroendocrine Tumor Research Advances"
    ]
  ],
  "openalex": "W7204700737",
  "pdf_url": "https://hal.science/hal-05752715/document",
  "pmcid": null,
  "pmid": "42691743",
  "published": "2026-09-17",
  "publisher": "Elsevier",
  "ris": "https://research.draconitic.com/paper/6jg2ka5c37463.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:17:35Z",
      "native_id": "hal-05752715",
      "source": "hal",
      "url": "https://hal.science/hal-05752715v1"
    }
  ],
  "subjects": [
    {
      "field": "biology",
      "origin": "hal:0.sdv",
      "subfield": "general"
    },
    {
      "field": "medicine",
      "origin": "hal:1.sdv.can",
      "subfield": "oncology"
    }
  ],
  "title": "Diagnostic pitfalls and unmet needs in neuroendocrine neoplasms: The added value of collegial expert pathology review through the national TENpath network",
  "title_text": "Diagnostic pitfalls and unmet needs in neuroendocrine neoplasms: The added value of collegial expert pathology review through the national TENpath network",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:17:35Z",
  "url": "https://research.draconitic.com/paper/6jg2ka5c37463",
  "venue": "European Journal of Cancer",
  "versions": []
}