Clinical management of patients with gastric neuroendocrine neoplasms associated with chronic atrophic gastritis: a retr
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ORIGINAL ARTICLE
Clinical management of patients with gastric neuroendocrine neoplasms associated with chronic atrophic gastritis: a retrospective, multicentre study Davide Campana1 • Davide Ravizza2 • Piero Ferolla3 • Antongiulio Faggiano4 • Franco Grimaldi5 • Manuela Albertelli6,7 • Debora Berretti5 • Danilo Castellani8 Giulia Cacciari1 • Nicola Fazio2 • Annamaria Colao4 • Diego Ferone6,7 • Paola Tomassetti1
•
Received: 10 January 2015 / Accepted: 19 March 2015 Ó Springer Science+Business Media New York 2015
Abstract To provide data regarding clinical presentation, pathological features, management, and response to different treatments of patients with type I gastric neuroendocrine tumors in stages 0–2A. The study design consist of an Italian multicentre, retrospective analysis of patients with type I gastric neuroendocrine tumors managed with different therapeutic approaches: surgery, endoscopic surveillance, endoscopic resection, or somatostatin analog therapy. Among the 97 patients included, 3 underwent surgery, 45 (46.4 %) radical endoscopic resection of the neoplastic lesions, 13 (13.4 %) follow-up with upper endoscopy, and 36 (37.1 %) somatostatin analog therapy. At & Davide Campana [email protected] 1
Department of Medical and Surgical Sciences, S.OrsolaMalpighi University Hospital, University of Bologna, Via Massarenti, 9, 40138 Bologna, Italy
2
Division of Endoscopy and Unit of Gastrointestinal and Neuroendocrine Tumours, European Institute of Oncology, Milan, Italy
the end of the follow-up, all patients were alive and there was no evidence of metastatic disease. Somatostatin analog therapy resulted in a complete response in 76.0 % of the patients and stable disease in 24.0 %. A prolonged period of therapy, the use of a full dose of somatostatin analogs and higher gastrin levels at diagnosis were related to a complete response to the therapy. The recurrence rate was 26.3 % in patients treated with somatostatin analog therapy and 26.2 % in patients treated with endoscopic resection, without a statistically significant difference in terms of disease-free survival. Regarding recurrence of the disease, no statistical difference was found according to type of therapy, number of neoplastic lesions, and 2010 WHO classification. The only risk factor for tumor recurrence was a short period of medical treatment. In conclusion, our study suggested that endoscopic surveillance, endoscopic resection and somatostatin analog therapy represent valid options in the management of patients with type I gastric neuroendocrine tumors in stages 0–2A.
3
Department of Medical Oncology, Multidisciplinary NET Center, Umbria Regional Cancer Network, Umbria, Italy
Keywords Neuroendocrine tumors Chronic atrophic gastritis Gastric carcinoid Somatostatin analogs Endoscopic resection
4
Division of Endocrinology, Department of Clinical Medicine and Surgery, ‘‘Federico II’’ University of Naples, Naples, Italy
Introduction
5
Endocrinology and Metabolism Unit, University Hospital S. Maria della Misericordia, Ud
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