Somatostatin analogs for gastric carcinoids: For many, but not all

Sara Massironi, Alessandra Zilli, Dario Conte

Research output: Contribution to journalArticle

Abstract

Gastric carcinoids (GCs) are classified as: type I, related to hypergastrinemia due to chronic atrophic gastritis (CAG), type II, associated with Zollinger-Ellison syndrome in multiple endocrine neoplasia type 1, and type III, which is normogastrinemic. The management of type-I gastric carcinoids (GC1s) is still debated, because of their relatively benign course. According to the European Neuroendocrine Tumor Society guidelines endoscopic resection is indicated whenever possible; however, it is not often feasible because of the presence of a multifocal disease, large lesions, submucosal invasion or, rarely, lymph node involvement. Therefore, somatostatin analogs (SSAs) have been proposed as treatment for GC1s in view of their antisecretive, antiproliferative and antiangiogenic effects. However, in view of the high cost of this therapy, its possible side effects and the relatively benign course of the disease, SSAs should be reserved to specific subsets of "high risk patients", i.e. , those patients with multifocal or recurrent GCs. Indeed, it is reasonable that, after the development of a gastric neuroendocrine neoplasm in patients with a chronic predisposing condition (such as CAG), other enterochromaffin-like cells can undergo neoplastic proliferation, being chronically stimulated by hypergastrinemia. Therefore, definite indications to SSAs treatment should be established in order to avoid the undertreatment or overtreatment of GCs.

Original languageEnglish
Pages (from-to)6785-6793
Number of pages9
JournalWorld Journal of Gastroenterology
Volume21
Issue number22
DOIs
Publication statusPublished - Jun 14 2015

Keywords

  • Atrophic gastritis
  • Carcinoid tumors
  • Enterochromaffin-like cells
  • Lanreotide
  • Neuroendocrine tumors
  • Octreotide

ASJC Scopus subject areas

  • Gastroenterology

Fingerprint Dive into the research topics of 'Somatostatin analogs for gastric carcinoids: For many, but not all'. Together they form a unique fingerprint.

  • Cite this