Type I Gastric Carcinoids: A Prospective Study on Endoscopic Management and Recurrence Rate

• Published in: Neuroendocrinology Vol. 95; no. 3; pp. 207 - 213
• Main Authors: Merola, Elettra, Sbrozzi-Vanni, Andrea, Panzuto, Francesco, D’Ambra, Giancarlo, Di Giulio, Emilio, Pilozzi, Emanuela, Capurso, Gabriele, Lahner, Edith, Bordi, Cesare, Annibale, Bruno, Delle Fave, Gianfranco
• Format: Journal Article
• Language: English
• Published: Basel, Switzerland S. Karger AG 01.01.2012
• Subjects: Adult; Aged; Aged, 80 and over; Carcinoid Tumor - surgery; Endoscopy - methods; Female; Follow-Up Studies; Gastritis, Atrophic; Humans; Male; Middle Aged; Neoplasm Recurrence, Local - prevention & control; Original Paper; Proportional Hazards Models; Retrospective Studies; Risk Factors; Stomach Neoplasms - surgery; Survival Rate; Treatment Outcome; Young Adult; Recurrence; Atrophic gastritis; Gastric carcinoid; Endoscopic management; Follow-up
• ISSN: 0028-3835; 1423-0194; 1423-0194
• DOI: 10.1159/000329043

Background: Type I gastric carcinoids (TIGCs) are neuroendocrine neoplasms arising from enterochromaffin-like cells in atrophic body gastritis. Data regarding their evolution in prospective series are scarce, thus treatment and follow-up are not codified. Our aim was to evaluate clinical outcome and recurrence in TIGCs managed by endoscopic approach. Methods: 33 patients (24 females; median age 65 years, range 23–81) were included and managed through endoscopic follow-up every 6–12 months, with lesion removal and multiple gastric biopsies. Baseline clinical and histological features were analyzed as risk factors by Cox regression. Results: At diagnosis, 7 tumors were intramucosal carcinoids and 26 were polyps (median diameter 5 mm, range 2–20), multiple in 17 patients. Associated severe atrophy was present in 21 cases (63.6%), while mild atrophy was found in 6 cases (18.2%). During a 46-month median follow-up, survival was 100% and no metastases occurred. One patient developed a less-differentiated carcinoid that was radically treated by surgery. 21 patients (63.6%) had recurrence after a median of 8 months, 14 of these (66.6%) had a second recurrence after a median of 8 months following the previous carcinoid removal. Median recurrence-free survival was 24 months. Neither clinical nor biochemical recurrence-predicting factors were found. Conclusions: Although about 60% of TIGCs had recurrence after endoscopic resection, endoscopic management may be considered safe and effective.