Prognosis of Gastric Carcinoid Tumours

Abstract

With the aim of evaluating the prognosis of carcinoid tumours of the stomach, the tumours were classified into subtypes on the basis of the type of gastritis, and a comparison made of the type of treatment, metastasizing rate, and the survival rates of the various groups of patients involved. Of the patients with atrophic autoimmune gastritis (type A gastritis) (n = 88) who had multiple carcinoid tumours in the corpus or fundus, usually not more than 1 cm in diameter, 98% were followed up clinically or by endoscopy and biopsy. In these patients, the metastasizing rate was 0%, and the age-corrected Kaplan-Meier survival rate revealed normal life expectancy. 25% of the patients with sporadic carcinoid tumours (n = 12) – most of whom had a Helicobacter pylori-related gastritis and usually solitary tumours located within the corpus or fundus, 25% of which exceeding 1 cm in diameter – underwent surgical treatment. In these patients the metastasizing rate was 16.7% and the age-corrected survival rate 79%. On the basis of our results, we conclude that, depending upon the subtype involved, the prognosis of gastric carcinoid tumours varies, such that regular endoscopy/biopsy follow-up suffices for patients with type A gastritis, while for patients with sporadic carcinoid tumours, surgical treatment is indicated.

Long-term follow up of patients with multiple gastric carcinoids associated with type A gastritis

“…Hori et al [14] reported a patient who showed neither new lesions nor recurrence despite having persistent hypergastrinemia for 12 years after endoscopic mucosal resection for gastric carcinoid tumor. Rappel et al [15] reported that the age-corrected Kaplan-Meier survival rate revealed normal life expectancy in 87 patients with multiple carcinoid tumors associated with type A gastritis; in 98% of these patients, the tumors had not been removed.…”

79-Year-Old Woman With Forgetfulness

“…17 Among carcinoid subtypes, type I lesions have been reported to be associated with an overall survival of about 78% at 5 years, 18 and type II 5-year survivals are reported at between 62% and 75%. 19 The 5-year survival for type III carcinoids is, not surprisingly, worse, at less than 50%. 20 Gastric carcinoids vary from a local disease that is treated via endomucosal excision to an extensively metastatic disease that requires surgery and chemotherapy.…”

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

“…The European Neuroendocrine Tumor Society (ENETS) Consensus Guidelines have suggested that annual surveillance is sufficient in case of GC1s with a diameter < 10 mm ø [8] . This approach is supported by some reports [24,[38][39][40] which suggest that careful endoscopic follow-up might represent a reasonable safe option in selected patients. However, further studies evaluating larger cohorts during a longer follow-up period are necessary in order to support this clinical behavior, as some cases of progressive malignant GC1s have already been reported [17][18][19]41] .…”