 Prospective observational study comparing ablative measures as TACE or SIRT with surgeryRFA and with peptide receptor radio-therapy in patients with advanced well-differentiated neuroendocrine tumors with lymph node or distant metastases N1, M1 Prospective evaluation Primary end points: time to progression Secondary end points: survival, quality of life EORTC-QLQ30, weight, time of hospitalization, Karnofsky index Non-randomized cohort study Number of patients needed in all groups: 70 per group, 210 overall Evaluation of response to therapy every 3-6 months by imaging, clinical status, weight, quality of life, Karnofsky-index Cross-over allowed if therapy changes 