Efficacy of Neoadjuvant Chemotherapy in Terms of DFS in Patients With Localized Digestive Neuroendocrine Carcinomas

Inclusion Criteria: Phase II

1. Histologically proven digestive CNE, (the WHO 2017 classification: poorlydifferentiated and Ki 67 > 20%),
2. Patients with localized CNE, without metastasis (computed tomography [CT],thoraco-abdominopelvic CT scan [TAP] according to RECIST 1.1; examinations performedno later than 21 days before starting the study treatment, possible locoregional lymphnode involvement defined according to the TNM classification),
3. Positron emission tomography (PET) and CT for lymph node status and elimination ofsecondary visceral and/or bone disorders, 4. Resectable tumor, according to theconsensus decision made during local multidisciplinary surgical consultation meeting,
4. Age ≥ 18 years, 6. Written informed consent obtained from the patient, willing and ableto comply with the protocol, 7. Registration in a National Health Care System (ProtectionUniverselle Maladie [PUMa] included), 8. For female patients of childbearing potential,negative pregnancy test within 7 days before starting the study treatment. Men and women are required to use a reliable and adequate birth control during the study (if applicable) during the period of treatment and during 6 months from the last treatmentadministration. Prospective cohort
5. Patients with localized digestive CNE histologically proven on the operative specimen (the WHO 2017 classification: poorly differentiated and Ki 67> 20%),
6. Localized, without metastasis on computed tomography [CT], thoracoabdominopelvic CTscan [TAP] RECIST 1.1, and/or locoregional lymph node involvement,
7. Age ≥ 18 years,
8. Written informed consent obtained from the patient, willing and able to comply withthe protocol,
9. Registration in a National Health Care System (PUMa - Protection Universelle Maladieincluded),
10. For female patients of childbearing potential, negative pregnancy test within 7 daysbefore starting the study treatment. Men and women are required to use a reliable and adequate birth control methods during thestudy (if applicable) during the period of treatment and during 6 months from the lasttreatment administration.

Exclusion Criteria: Phase II

1. Well-differentiated NEC, whatever the grade,
2. Metastatic disease,
3. Cancer of unknown primary
4. Organ failure that does not allow chemotherapy treatment,
5. Previous malignancy within 5 years prior to the study except for cutaneous basal cellcarcinoma and uterine cancer in situ
6. Tumor with a mixed component (component accounts for ≥ 30%),
7. Patient impossible to follow-up,
8. Other than platinum-etoposide chemotherapy administrated,
9. Tutelage or guardianship or patient protected by law Prospective cohort
10. Well-differentiated NEC, whatever the grade,
11. Metastatic disease,
12. Cancer of unknown primary
13. Organ failure that does not allow chemotherapy treatment,
14. Previous malignancy within 5 years prior to the study except for cutaneous basal cellcarcinoma and uterine cancer in situ
15. Tumor with a mixed component (component accounts for ≥ 30%),
16. Patient impossible to follow-up,
17. Other than platinum-etoposide chemotherapy administrated,
18. Tutelage or guardianship or patient protected by law.