TY - JOUR
T1 - Clinical management of patients with gastric neuroendocrine neoplasms associated with chronic atrophic gastritis
T2 - a retrospective, multicentre study
AU - Campana, Davide
AU - Ravizza, Davide
AU - Ferolla, Piero
AU - Faggiano, Antongiulio
AU - Grimaldi, Franco
AU - Albertelli, Manuela
AU - Berretti, Debora
AU - Castellani, Danilo
AU - Cacciari, Giulia
AU - Fazio, Nicola
AU - Colao, Annamaria
AU - Ferone, Diego
AU - Tomassetti, Paola
PY - 2016/1/1
Y1 - 2016/1/1
N2 - To provide data regarding clinical presentation, pathological features, management, and response to different treatments of patients with type I gastric neuroendocrine tumors in stages 0–2A. The study design consist of an Italian multicentre, retrospective analysis of patients with type I gastric neuroendocrine tumors managed with different therapeutic approaches: surgery, endoscopic surveillance, endoscopic resection, or somatostatin analog therapy. Among the 97 patients included, 3 underwent surgery, 45 (46.4 %) radical endoscopic resection of the neoplastic lesions, 13 (13.4 %) follow-up with upper endoscopy, and 36 (37.1 %) somatostatin analog therapy. At the end of the follow-up, all patients were alive and there was no evidence of metastatic disease. Somatostatin analog therapy resulted in a complete response in 76.0 % of the patients and stable disease in 24.0 %. A prolonged period of therapy, the use of a full dose of somatostatin analogs and higher gastrin levels at diagnosis were related to a complete response to the therapy. The recurrence rate was 26.3 % in patients treated with somatostatin analog therapy and 26.2 % in patients treated with endoscopic resection, without a statistically significant difference in terms of disease-free survival. Regarding recurrence of the disease, no statistical difference was found according to type of therapy, number of neoplastic lesions, and 2010 WHO classification. The only risk factor for tumor recurrence was a short period of medical treatment. In conclusion, our study suggested that endoscopic surveillance, endoscopic resection and somatostatin analog therapy represent valid options in the management of patients with type I gastric neuroendocrine tumors in stages 0–2A.
AB - To provide data regarding clinical presentation, pathological features, management, and response to different treatments of patients with type I gastric neuroendocrine tumors in stages 0–2A. The study design consist of an Italian multicentre, retrospective analysis of patients with type I gastric neuroendocrine tumors managed with different therapeutic approaches: surgery, endoscopic surveillance, endoscopic resection, or somatostatin analog therapy. Among the 97 patients included, 3 underwent surgery, 45 (46.4 %) radical endoscopic resection of the neoplastic lesions, 13 (13.4 %) follow-up with upper endoscopy, and 36 (37.1 %) somatostatin analog therapy. At the end of the follow-up, all patients were alive and there was no evidence of metastatic disease. Somatostatin analog therapy resulted in a complete response in 76.0 % of the patients and stable disease in 24.0 %. A prolonged period of therapy, the use of a full dose of somatostatin analogs and higher gastrin levels at diagnosis were related to a complete response to the therapy. The recurrence rate was 26.3 % in patients treated with somatostatin analog therapy and 26.2 % in patients treated with endoscopic resection, without a statistically significant difference in terms of disease-free survival. Regarding recurrence of the disease, no statistical difference was found according to type of therapy, number of neoplastic lesions, and 2010 WHO classification. The only risk factor for tumor recurrence was a short period of medical treatment. In conclusion, our study suggested that endoscopic surveillance, endoscopic resection and somatostatin analog therapy represent valid options in the management of patients with type I gastric neuroendocrine tumors in stages 0–2A.
KW - Chronic atrophic gastritis
KW - Endoscopic resection
KW - Gastric carcinoid
KW - Neuroendocrine tumors
KW - Somatostatin analogs
UR - http://www.scopus.com/inward/record.url?scp=84953837485&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84953837485&partnerID=8YFLogxK
U2 - 10.1007/s12020-015-0584-z
DO - 10.1007/s12020-015-0584-z
M3 - Article
AN - SCOPUS:84953837485
VL - 51
SP - 131
EP - 139
JO - Endocrine
JF - Endocrine
SN - 1355-008X
IS - 1
ER -