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Endocrine

, Volume 57, Issue 3, pp 504–511 | Cite as

Management of gastric neuro-endocrine tumours in a large French national cohort (GTE)

  • Sylvain Manfredi
  • Thomas Walter
  • Eric Baudin
  • Romain Coriat
  • Philippe Ruszniewski
  • Thierry Lecomte
  • Anne-Pascale Laurenty
  • Bernard Goichot
  • Vincent Rohmer
  • Guillaume Roquin
  • Oana-Zvetlana Cojocarasu
  • Catherine Lombard-Bohas
  • Côme Lepage
  • Jeff Morcet
  • Guillaume Cadiot
Original Article
  • 136 Downloads

Abstract

Introduction

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.

Results

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.

Conclusion

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.

Keywords

Gastric neuro-endocrine tumour Treatment Survival Cohort 

Notes

Acknowledgements

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.

Funding

The study was supported by a fund from Ipsen Pharma SAS.

Author contributions

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.

Ethical approval

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

Informed consent was obtained from all individual participants included in the study.

References

  1. 1.
    M. Fraenkel, M.K. Kim, A. Faggiano, G.D. Valk, Epidemiology of gastroenteropancreatic neuroendocrine tumours. Best Pract. Res. Clin. Gastroenterol. 26, 691–703 (2012)CrossRefPubMedGoogle Scholar
  2. 2.
    C. Lepage, A.M. Bouvier, J.M. Phelip, C. Hatem, C. Vernet, J. Faivre, Incidence and management of malignant digestive endocrine tumours in a well-defined French population. Gut 53, 549–553 (2004)CrossRefPubMedPubMedCentralGoogle Scholar
  3. 3.
    I.M. Modlin, K.D. Lye, M. Kidd, A 50-year analysis of 562 gastric carcinoids: small tumor or larger problem? Am. J. Gastroenterol. 99, 23–32 (2004)CrossRefPubMedGoogle Scholar
  4. 4.
    C.S. Landry, G. Brock, C.R. Scoggins, K.M. McMasters, R.C. Martin 2nd, A proposed staging system for gastric carcinoid tumors based on an analysis of 1,543 patients. Ann. Surg. Oncol. 16, 51–60 (2009)CrossRefPubMedGoogle Scholar
  5. 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
  6. 6.
    L. Vannella, A. Sbrozzi-Vanni, E. Lahner et al., Development of type I gastric carcinoid in patients with chronic atrophic gastritis. Aliment. Pharmacol. Ther. 33, 1361–1369 (2011)CrossRefGoogle Scholar
  7. 7.
    F. Gibril, M. Schumann, A. Pace et al., Multiple endocrine neoplasia type 1 and Zollinger- Ellison syndrome: a prospective study of 107 cases and comparison with 1,009 cases from the literature. Medicine 83, 43–83 (2004)CrossRefGoogle Scholar
  8. 8.
    K. Borch, B. Ahren, H. Ahlman et al., Gastric carcinoids: biologic behavior and prognosis after differentiated treatment in relation to type. Ann. Surg. 242, 64–73 (2005)CrossRefPubMedCentralGoogle Scholar
  9. 9.
    G. Rindi, C. Azzoni, S. La Rosa et al., ECL cell tumor and poorly differentiated endocrine carcinoma of the stomach: prognostic evaluation by pathological analysis. Gastroenterology 116, 532–542 (1999)CrossRefPubMedGoogle Scholar
  10. 10.
    H. Scherübl, G. Cadiot, R.T. Jensen, T. Rösch, U. Stölzel, G. Klöppel, Neuroendocrine tumors of the stomach (gastric carcinoids) are on the rise: small tumors, small problems? Endoscopy 42, 664–671 (2010)CrossRefPubMedGoogle Scholar
  11. 11.
    S. Rappel, A. Altendorf-Hofmann, M. Stolte, Prognosis of gastric carcinoid tumours. Digestion 56, 455–462 (1995)CrossRefPubMedGoogle Scholar
  12. 12.
    Y. Sato, H. Imamura, Y. Kaizaki et al., Management and clinical outcomes of type I gastric carcinoid patients: retrospective, multicenter study in Japan. Dig. Endosc. 26, 377–384 (2014)CrossRefPubMedGoogle Scholar
  13. 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
  14. 14.
    E. Merola, A. Sbrozzi-Vanni, F. Panzuto et al., Type I gastric carcinoids: a prospective study on endoscopic management and recurrence rate. Neuroendocrinology. 95, 207–213 (2012)CrossRefPubMedGoogle Scholar
  15. 15.
    W.C. Chen, R.R. Warner, S.C. Ward et al., Management and disease outcome of type I gastric neuroendocrine tumors: the Mount Sinai experience. Dig. Dis. Sci. 60, 996–1003 (2015)CrossRefPubMedGoogle Scholar
  16. 16.
    Y. Sato, S. Hashimoto, K. Mizuno, M. Takeuchi, S. Terai, Management of gastric and duodenal neuroendocrine tumors. World J. Gastroenterol. 22, 6817–6828 (2016)CrossRefPubMedPubMedCentralGoogle Scholar
  17. 17.
    G. Delle Fave, D.J. Kwekkeboom, E. Van Cutsem, G. Rindi, B. Kos-Kudla, U. Knigge, H. Sasano, P. Tomassetti, R. Salazar, P. Ruszniewski, ENETS consensus guidelines for the management of patients with gastroduodenal neoplasms. Neuroendocrinology 95, 74–87 (2012)CrossRefPubMedGoogle Scholar
  18. 18.
    E. Solcia, G. Kloppel, L.H. Sobin, Histological typing of endocrine tumours. In international histological classification of tumours, 2nd edn. (Springer, Berlin Heidelberg, 2000) pp. 61–68CrossRefGoogle Scholar
  19. 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
  20. 20.
    C. Lepage, B. Rachet, M.P. Coleman, Survival from malignant digestive endocrine tumors in England and Wales: a population-based study. Gastroenterology 132, 899–904 (2007)CrossRefPubMedGoogle Scholar
  21. 21.
    C. Lepage, L. Ciccolallo, R. De Angelis, A.M. Bouvier, J. Faivre, G. Gatta, The EUROCARE working group, European disparities in malignant digestive endocrine tumours survival. Int. J. Cancer 126, 2928–2934 (2010)PubMedGoogle Scholar
  22. 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
  23. 23.
    R.A. Gladdy, V.E. Strong, D. Coit, P.J. Allen, H. Gerdes, J. Shia, D.S. Klimstra, F.B. Murray, L.H. Tang, Defining surgical indications for type I gastric carcinoid tumor. Ann. Surg. Oncol. 16, 3154–3160 (2009)CrossRefPubMedGoogle Scholar
  24. 24.
    D. Ravizza, G. Fiori, C. Trovato, N. Fazio, G. Bonomo, F. Luca, L. Boder, G. Pelosi, D. Tamayo, C. Crosta, Long-term endoscopic and clinical follow-up of untreated type 1 gastric neuroendocrine tumours. Dig. Liver. Dis. 39, 537–543 (2007)CrossRefPubMedGoogle Scholar
  25. 25.
    S. Manfredi, M. Pagenault, A.S. de Lajarte-Thirouard, J.F. Bretagne, Type 1 and 2 gastric carcinoid tumors: long-term follow-up of the efficacy of treatment with a slow-release somatostatin analogue. Eur. J. Gastroenterol. Hepatol. 19, 1021–1025 (2007)CrossRefPubMedGoogle Scholar
  26. 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
  27. 27.
    D. Campana, F. Nori, R. Pezzilli, L. Piscitelli, D. Santini, E. Brocchi, R. Corinaldesi, P. Tomassetti, Gastric endocrine tumors type I: treatment with long-acting somatostatin analogs. Endocr. Relat. Cancer 15, 337–342 (2008)CrossRefPubMedGoogle Scholar
  28. 28.
    M.S. Khuroo, M.S. Khuroo, N.S. Khuroo, Treatment of type I gastric neuroendocrine tumors with somatostatin analogs. J. Gastroenterol. Hepatol. 25, 548–554 (2010)CrossRefPubMedGoogle Scholar
  29. 29.
    P. Tomassetti, M. Migliori, G.C. Caletti, P. Fusaroli, R. Corinaldesi, L. Gullo, Treatment of type II gastric carcinoid tumors with somatostatin analogues. N. Engl. J. Med. 343, 551–554 (2000)CrossRefGoogle Scholar
  30. 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
  31. 31.
    S. Massironi, V. Sciola, M. Pia Spampatti, M. Peracchi, D. Conte, Gastric carcinoids: between underestimation and overtreatment. World J. Gastroenterol. 15, 2177–2183 (2009)CrossRefPubMedPubMedCentralGoogle Scholar
  32. 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. 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
  34. 34.
    D. O’Toole, G. Delle Fave, R.T. Tensen, Gastric and duodenal neuroendocrine tumours. Best Pract. Res. Clin. Gastroenterol. 26, 719–735 (2012)CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2017

Authors and Affiliations

  • Sylvain Manfredi
    • 1
  • Thomas Walter
    • 2
  • Eric Baudin
    • 3
  • Romain Coriat
    • 4
  • Philippe Ruszniewski
    • 5
  • Thierry Lecomte
    • 6
  • Anne-Pascale Laurenty
    • 7
  • Bernard Goichot
    • 8
  • Vincent Rohmer
    • 9
  • Guillaume Roquin
    • 10
  • Oana-Zvetlana Cojocarasu
    • 11
  • Catherine Lombard-Bohas
    • 2
  • Côme Lepage
    • 1
  • Jeff Morcet
    • 12
  • Guillaume Cadiot
    • 13
  1. 1.CHU Dijon, hepato-gastroenterology unitUniversity of Bourgogne Franche-Comté, INSERM, LNC UMR1231DijonFrance
  2. 2.Département d’Oncologie MédicaleHospices Civils de Lyon, Hôpital Edouard HerriotLyonFrance
  3. 3.Gustave Roussy, Département d’Oncologie EndocrinienneVillejuif cedexFrance
  4. 4.Department of Gastroenterology and Digestive Oncology, Cochin Teaching HospitalParis Descartes UniversityParisFrance
  5. 5.Beaujon Hospital and Paris Diderot UniversityClichyFrance
  6. 6.CHRU de Tours, service d’Hépato-Gastroenterologie, CNRS, UMR 7292, GICC & Université Francois-RabelaisToursFrance
  7. 7.Department of Medical OncologyInstitut Claudius RegaudToulouseFrance
  8. 8.Department of Internal Medicine, Endocrinology and NutritionHôpitaux Universitaires de Strasbourg, Faculté de Médecine, Université de StrasbourgStrasbourgFrance
  9. 9.Service d’endocrinologie et maladies métaboliques, CHU d’AngersAngersFrance
  10. 10.Service d’Hépato-Gastro-Entérologie, CHU AngersAngersFrance
  11. 11.CH Le MansLe MansFrance
  12. 12.CIC, Université de Rennes 1RennesFrance
  13. 13.Department of Hepato-Gastroenterology and Digestive OncologyRobert-Debré University HospitalReimsFrance

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