History of Uppsala Centre of Excellence

Uppsala siluette. Photo: Marcus Marcetic

Since the late 70’s, a deliberate effort on research and development of diagnosis and therapy of endocrine tumors has been pursued by the Department of Endocrine Oncology and Endocrine Surgery at Uppsala University Hospital. Thus, new diagnostic procedures have been developed, including biochemical markers, somatostatin receptor imaging, positron emission tomography with specific tracers such as 11C-5-HTP, 68Ga-DOTATOC. New therapies have been introduced including somatostatin analogs, interferon, peptide receptor radiotherapy, targeted treatment with m-TOR and tyrosine kinase inhibitors as well as anti-angiogenic treatment. Embolization of liver metastases is performed including radio-embolization with radioactive micro-particles. New surgical techniques for small intestinal tumors and other neuroendocrine tumors have been developed.

The tumor biology program include biomarkers for early detection and also markers of proliferation and staging of the disease using the most recent staging programs, developed by European Neuroendocrine Tumor Society (TNM staging and grading system), which enables individualization of treatment. As a consequence quality of life and survival rate have significantly improved over the last decades.

In order to give the patient an optimal multimodal management collaboration with other units specialities such as radiology, clinical chemistry, pathology, nuclear medicine, cardiology, thoracic surgery and the PET-centre has been established. Patient’s advocacy groups are also involved in the care (CARPA). A Tumor Board including all the specialities mentioned above is regularly discussing the patient management. A large number of patients (around 3000) have been evaluated and treated and since 1986 the Department of Endocrine Oncology has been a national referral centre. At present 20-30% of patients come from other countries also outside Scandinavia and Europe indicating that the centre has received the status of a Centre of Excellence. In 2009 Department of Endocrine Oncology was certified by the European Neuroendocrine Tumor Society (ENETS) as an Centre of Excellence for management of neuroendocrine tumors.