Effects of tumor types on treatment strategy formulation and prognostic evaluation of gastric neuroendocrine tumors

Abstract

Aim: The effects of different types of gastric neuroendocrine tumors (G-NETs) on treatment strategy formulation and prognostic evaluation still remain controversial due to their rarity. Methods: 187 patients diagnosed with G-NETs were subdivided into four types based on the pathophysiology, etiology and presentation. Results: Type I, II G-NETs >1.0 cm and type III, IV G-NETs >2.0 cm are proved with aggressive behavior (p < 0.05). Type III G-NETs with higher Ki-67 index and tumor stage showed more invasive potential than type I and II G-NETs (p < 0.05). Endoscopic resection is the primary treatment for type I, II G-NETs, while surgical combined with chemotherapy is associated with favorable outcomes for type IV G-NETs. Conclusion: The clinical classifications of G-NETs are of great significance for the choice of treatment and the evaluation of prognosis.

Defining prognostic parameters of well-differentiated gastric neuroendocrine tumors based on metastatic potential: a two-center experience

“…In our cohort, type-3 gNETs occurred solitary, were greater in size and more invasive in growth in comparison with type-1 gNETs, and had a worse prognosis with significantly higher metastatic potential (11,12). This is in agreement with existing literature.…”

Gastric Neuroendocrine Tumors (g-NETs): A Systematic Review of the Management and Outcomes of Type 3 g-NETs

“…In 21 studies, the origin of the tumor site was predominantly the gastric corpus/fundus (83.3%) [ 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 ], and prevalent polypoid morphology from endoscopy was identified in 13 out of the 31 studies [ 15 , 16 , 17 , 20 , 21 , 22 , 23 , 25 , 26 , 28 , 29 , 30 , 31 ]. A total of 17 out of the 31 studies included tumor depth invasion data, resulting in an invasion that included the submucosa in most cases [ 15 , 16 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 28 , 30 , 32 , 34 , 35 , 36 , 37 , 38 ]. A total of 26 out of the 31 papers reported dimensional data, and the median size was 16.5 mm (8–62.5 mm) [ 14 ,…”

Gastroduodenal neuroendocrine neoplasms including gastrinoma — update of the diagnostic and therapeutic guidelines (recommended by the Polish Network of Neuroendocrine Tumours) [Nowotwory neuroendokrynne żołądka i dwunastnicy z uwzględnieniem gastrinoma — uaktualnione zasady postępowania (rekomendowane przez Polską Sieć Guzów Neuroendokrynnych)]

“…Despite ambiguous reports on adjuvant treatment after radical surgery, in the case of NETs G3 and NECs with a high proliferative index (Ki-67 > 55%), adjuvant treatment should be considered, and in some cases of SCNECs, combination therapy may be considered -radiochemotherapy or sequential treatment -chemotherapy followed by radiotherapy as an analogy to the treatment of small cell lung cancer [82][83][84][85].…”

“…Pomimo niejednoznacznych doniesień dotyczących leczenia uzupełniającego po radykalnym leczeniu chirurgicznym u chorych z NET G3 i NEC o wysokim indeksie proliferacyjnym (Ki-67 > 55%) należy rozważyć leczenie uzupełniające, a w niektórych przypadkach raków neuroendokrynnych drobnokomórkowych można rozważyć leczenie skojarzone -radiochemioterapią lub leczenie sekwencyjne -chemioterapię z następową radioterapią jako analogię do leczenia drobnokomórkowego raka płuca [82][83][84][85].…”