Management of gastric neuro-endocrine tumours in a large French national cohort (GTE)
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Gastric neuro-endocrine tumours are rare. European guidelines for the management of neuro-endocrine tumours have been published in 2012. The aim of our survey was to study the management of gastric neuro-endocrine tumours registered in the national cohort. A prospective national cohort registers the Neuro-endocrine tumours in France since January 2003 (GTE network). We reviewed all the individual medical reports of gastric neuro-endocrine tumours in order to collect data on treatment.
One hundred and ninety seven gastric neuro-endocrine tumours diagnosed between 1964 and 2013 in 20 centres were registered. For 181 cases data were considered complete for our survey. Eighty four tumours were type 1 (46.4%); five types 2 (2.8%); 52 types 3 (28.7%) and 40 types 4 (22.1%). Types 1 and 2 were first endoscopically managed in 93 and 60% of cases, respectively, whereas surgery was first done in 45 and 42%, respectively, of types 3 and 4. Systemic treatment, chemotherapy and/or somatostatin analogue, was first administered exclusively for types 3 and 4. Near 3% of types 1 and 40% of types 2 received at a time somatostatin analogue treatment. Five-year survival rates were 98.3, 100, 63.2 and 31.8% for types 1, 2, 3 and 4, respectively.
The great majority of gastric neuro-endocrine tumours registered in this national cohort are treated in accordance with the current guidelines. The survival rates we reported must be interpreted with caution, because this cohort registered preferentially selected patients eligible for treatment. The registration of all the gastric neuro-endocrine tumours, in particular type 1 considered as benign and type 4 not eligible for specific anti-cancer treatment must be encouraged.
KeywordsGastric neuro-endocrine tumour Treatment Survival Cohort
We are thankful to all the members of the two academics networks involved in this cohort: the GTE (group for the study of endocrine tumours) and RENATEN (national network for the treatment of endocrine tumours). All the patients and their family who gave consents for this study.
The study was supported by a fund from Ipsen Pharma SAS.
S.M.: drafted and designed the study, recruited patients, and wrote the paper. T.W., G.C.: recruited patients, revised the manuscript; E.B., R.C., P.R., T.L., A.P.L., B.G., V.R., G.R., O.Z.C., C.L.B., C.L.: recruited patients. J.M.: did the statistical analysis.
Compliance with ethical standards
Conflict of interest
authors declare that they have no competing interests.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The study was approved by the scientific committee of the national group for NETs (GTE) and the ethic committee of the university hospital of Rennes, France.
Informed consent was obtained from all individual participants included in the study.
- 5.M.B. Niederle, M. Hackl, K. Kaserer, B. Niederle, Gastroenteropancreatic neuroendocrine tumours: the current incidence and staging based on the WHO and European neuroendocrine tumour society classification: an analysis based on prospectively collected parameters. Endocr. Relat. Cancer 17, 909–918 (2010)CrossRefPubMedGoogle Scholar
- 13.D. Thomas, A.V. Tsolakis, S. Grozinsky-Glasberg, M. Fraenkel, K. Alexandraki, S. Sougioultzis, D.J. Gross, G. Kaltsas, Long-term follow-up of a large series of patients with type 1 gastric carcinoid tumors: data from a multicenter study. Eur. J. Endocrinol. 168, 185–193 (2013)CrossRefPubMedGoogle Scholar
- 19.L.H. Sobin, M. Gospodarowicz, C. Wittekind (eds.), UICC (International Union Against Cancer). TNM classification of malignant tumours. 7th edn. (Wiley-Blackwell, New York, 2009)Google Scholar
- 22.M.H. Kulke, L.B. Anthony, D.L. Bushnell, W.W. de Herder, S.J. Goldsmith, D.S. Klimstra, S.J. Marx, J.L. Pasieka, R.F. Pommier, J.C. Yao, R.T. Jensen, North American neuroendocrine tumor society (NANETS), NANETS treatment guidelines: well-differentiated neuroendocrine tumors of the stomach and pancreas. Pancreas 39, 735–752 (2010)CrossRefPubMedPubMedCentralGoogle Scholar
- 26.S. Grozinsky-Glasberg, G. Kaltsas, C. Gur, E. Gal, D. Thomas, S. Fichman, K. Alexandraki, D. Barak, B. Glaser, I. Shimon, D.J. Gross, Long-acting somatostatin analogues are an effective treatment for type 1 gastric carcinoid tumours. Eur. J. Endocrinol. 159, 475–482 (2008)CrossRefPubMedGoogle Scholar
- 30.D. Campana, D. Ravizza, P. Ferolla, A. Faggiano, F. Grimaldi, M. Albertelli, D. Berretti, D. Castellani, G. Cacciari, N. Fazio, A. Colao, D. Ferone, P. Tomassetti, Clinical management of patients with gastric neuroendocrine neoplasms associated with chronic atrophic gastritis: a retrospective, multicentre study. Endocrine 51, 131–139 (2016)CrossRefPubMedGoogle Scholar
- 32.A. Rinke, H.H. Müller, C. Schade-Brittinger, K.J. Klose, P. Barth, M. Wied, C. Mayer, B. Aminossadati, U.F. Pape, M. Bläker, J. Harder, C. Arnold, T. Gress, R. Arnold, PROMID Study Group, Placebo-controlled, double-blind, prospective, randomized study on the effect of octreotide LAR in the control of tumor growth in patients with metastatic neuroendocrine midgut tumors: a report from the PROMID study group. J. Clin. Oncol. 27, 4656–4663 (2009)CrossRefPubMedGoogle Scholar
- 33.M.E. Caplin, M. Pavel, J.B. Ćwikła, A.T. Phan, M. Raderer, E. Sedláčková, G. Cadiot, E.M. Wolin, J. Capdevila, L. Wall, G. Rindi, A. Langley, S. Martinez, J. Blumberg, P. Ruszniewski, CLARINET Investigators, Lanreotide in metastatic enteropancreatic neuroendocrine tumors. N. Engl. J. Med. 371, 224–233 (2014)CrossRefPubMedGoogle Scholar