Gastric Carcinoids

Borch, Kurt; Åhrén, Bo; Ahlman, Håkan; Falkmer, Sture; Granérus, Göran; Grimelius, Lars

doi:10.1097/01.sla.0000167862.52309.7d

Cited by 256 publications

(116 citation statements)

References 36 publications

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“…Type 2 gastric NENs occur in multiple endocrine neoplasia type 1 (MEN1) Zollinger-Ellison syndrome (ZES) patients, as multiple polyps in the gastric body and fundus, with hypertrophic surrounding mucosa, and low pH in the gastric aspirate (pH!2; Borch et al 2005, Ruszniewski et al 2006, Akerstrom & Hellman 2009, Å kerström et al 2009). The malignant potential is intermediate, with lymph node metastases in w30% and LM in 10-20%.…”

Section: Typementioning

confidence: 99%

“…Type 1 gastric NENs occur in patients with chronic atrophic gastritis (CAG), with hypergastrinemia due to the absence of gastric acid, as multiple, small gastric body and fundus polyps, together with mucosal atrophy and ECL-cell hyperplasia (Borch et al 2005, Ruszniewski et al 2006, Akerstrom & Hellman 2009, Å kerström et al 2009). Polyps !1 cm are generally indolent and can be followed with yearly endoscopic surveillance.…”

Section: Typementioning

confidence: 99%

See 1 more Smart Citation

Neuroendocrine tumor disease: an evolving landscape

Frilling

Åkerström

Falconi

et al. 2012

Endocrine-Related Cancer

149

106

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Gastroenteropancreatic neuroendocrine neoplasms (GEP-NENs) represent a heterogenous group of tumors arising from a variety of neuroendocrine cell types. The incidence and prevalence of GEPNENs have markedly increased over the last three decades. Symptoms are often absent in early disease, or vague and nonspecific even in advanced disease. Delayed diagnosis is thus common. Chromogranin A is the most commonly used biomarker but has limitations as does the proliferative marker Ki-67%, which is often used for tumor grading and determination of therapy. The development of a multidimensional prognostic nomogram may be valuable in predicting tumor behavior and guiding therapy but requires validation. Identification of NENs that express somatostatin receptors (SSTR) allows for SSTR scintigraphy and positron emission tomography imaging using novel radiolabeled compounds. Complete surgical resection of limited disease or endoscopic ablation of small lesions localized in stomach or rectum can provide cure; however, the majority of GEP-NENs are metastatic (most frequently the liver and/or mesenteric lymph nodes) at diagnosis. Selected patients with metastatic disease may benefit from advanced surgical techniques including hepatic resection or liver transplantation. Somatostatin analogs are effective for symptomatic treatment and exhibit some degree of antiproliferative activity in small intestinal NENs. There is a place for streptozotocin, temozolomide, and capecitabine in the management of pancreatic NENs, while new agents targeting either mTOR (everolimus) or angiogenic (sunitinib) pathways have shown efficacy in these lesions.

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Section: Typementioning

confidence: 99%

Section: Typementioning

confidence: 99%

Neuroendocrine tumor disease: an evolving landscape

Frilling

Åkerström

Falconi

et al. 2012

Endocrine-Related Cancer

149

106

View full text Add to dashboard Cite

show abstract

“…However, only a few studies evaluating relatively small cohorts have addressed in a specific and repetitive manner the exact pattern of their presentation (5,6). Data derived from personal experience and consensus statements (7) suggest that the majority of GC1 can be easily sampled or removed by either biopsy forceps or endoscopic mucosal resection (EMR), being small (!15 mm), rounded, mucosal, or submucosal lesions (8).…”

Section: Introductionmentioning

confidence: 99%

“…The therapeutic strategies for GC1 are based on risk stratification according to tumor size, number, stage, and grading, ranging from close endoscopic surveillance to surgery (5,11,12). However, there are relatively few studies evaluating the effectiveness of different therapeutic modalities in patients with prolonged follow-up.…”

Section: Introductionmentioning

confidence: 99%

Long-term follow-up of a large series of patients with type 1 gastric carcinoid tumors: data from a multicenter study

Thomas¹,

Tsolakis²,

Grozinsky‐Glasberg³

et al. 2013

European Journal of Endocrinology

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Objective: To study the clinical presentation, diagnostic approach, response to treatment, and the presence of other pathologies in patients with gastric carcinoid type 1 (GC 1) tumors. Design and methods: Retrospective analysis of 111 patients from four institutions and a mean follow-up of 76 months. Results: The main indications for gastroscopy were upper gastrointestinal tract symptoms. The mean number of lesions, maximum tumoral diameter, and percentage of cells expressing Ki-67 labeling index were 3.6G3.8, 8G12.1 mm and 1.9G2.4% respectively. Serum gastrin and chromogranin A (CgA) levels were elevated in 100/101 and 85/90 patients respectively. Conventional imaging studies demonstrated pathology in 9/111 patients. Scintigraphy with radiolabeled octreotide was positive in 6/60 without revealing any additional lesions. From the 59 patients who had been followed-up without any intervention, five developed tumor progression. Thirty-two patients were treated with long-acting somatostatin analogs (SSAs), leading to a significant reduction of gastrin and CgA levels, number of visible tumors, and CgA immune-reactive tumor cells in 28, 19, 27, and 23 treated patients respectively. Antrectomy and/or gastrectomy were initially performed in 20 patients and a complete response was achieved in 13 patients. The most common comorbidities were vitamin B12 deficiency, thyroiditis, and parathyroid adenomas. Conclusions: Most GCs1 are grade 1 (82.7%) tumors presenting with stage I (73.9%) disease with no mortality after prolonged follow-up. Ocreoscan did not provide further information compared with conventional imaging techniques. Treatment with SSAs proved to be effective for the duration of administration.

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“…Endoscopic observation is often all that is required in those with polyps !10 mm in size. The metastatic potential is very low, and in the majority of cases, only annual endoscopic surveillance is required with serial mucosal biopsies done due to the risk of gastric adenocarcinomas developing from intestinal metaplasia (Borch et al 2005). In larger tumours of 10-20 mm in size, endoscopic ultrasound (EUS) is required to assess depth of invasion, and endoscopic resection is recommended for up to six polyps not involving the muscularis propria.…”

Section: Stomachmentioning

confidence: 99%

Therapeutic management of patients with gastroenteropancreatic neuroendocrine tumours

Khan

Caplin²

2011

Endocrine-Related Cancer

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Patients with neuroendocrine tumours (NETs) are best managed in a specialist centre as part of a multidisciplinary team comprising gastroenterologists, oncologists, endocrinologists, gastrointestinal and hepatopancreaticobiliary surgeons, pathologists, nuclear medicine physicians and technicians, radiologists, specialist nurses, pharmacists, biochemists and dieticians. This should ideally be led by a clinician with experience and interest in NETs. Although the number of medical treatments and clinical trials has increased in the decade, there is still a lack of prospective randomised trials; thus, management is mainly based on limited often single-centre studies, although there are now formal guidelines based on consensus expert opinion. We have outlined the current optimal management of patients with NETs. We have reviewed therapeutic options including surgery, somatostatin analogues and other biotherapies and peptide receptor-targeted therapy. We have discussed the challenge in managing hepatic metastases including hepatic artery embolisation, ablation and orthotopic liver transplant. In addition, we have briefly reviewed the emerging therapies such as the mammalian target of rapamycin and angiogenic inhibitors and the newer somatostatin analogues.

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Gastric Carcinoids

Abstract: Subtyping of gastric carcinoids is helpful in the prediction of malignant potential and long-term survival and is a guide to management. Long-term survival did not differ from that of the general population regarding type 1 carcinoids but was poor regarding type 4 carcinoids.

Cited by 256 publications

References 36 publications

Neuroendocrine tumor disease: an evolving landscape

Neuroendocrine tumor disease: an evolving landscape

Long-term follow-up of a large series of patients with type 1 gastric carcinoid tumors: data from a multicenter study

Therapeutic management of patients with gastroenteropancreatic neuroendocrine tumours

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