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Clinical management of patients with gastric neuroendocrine neoplasms associated with chronic atrophic gastritis: a retrospective, multicentre study

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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 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.

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Acknowledgments

ALL authors approved the final version of the article, including the authorship list. Dr. Antongiulio Faggiano has received research grants from NOVARTIS Farma s.p.a. and IPSEN PHARMA. The others authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of Medical and Surgical Sciences, S.Orsola-Malpighi University Hospital, University of Bologna, Via Massarenti, 9, 40138, Bologna, Italy

    Davide Campana, Giulia Cacciari & Paola Tomassetti

  2. Division of Endoscopy and Unit of Gastrointestinal and Neuroendocrine Tumours, European Institute of Oncology, Milan, Italy

    Davide Ravizza & Nicola Fazio

  3. Department of Medical Oncology, Multidisciplinary NET Center, Umbria Regional Cancer Network, Umbria, Italy

    Piero Ferolla

  4. Division of Endocrinology, Department of Clinical Medicine and Surgery, “Federico II” University of Naples, Naples, Italy

    Antongiulio Faggiano & Annamaria Colao

  5. Endocrinology and Metabolism Unit, University Hospital S. Maria della Misericordia, Udine, Italy

    Franco Grimaldi & Debora Berretti

  6. Endocrinology, Department of Internal Medicine and Medical Specialties (DiMI) and Center of Excellence for Biomedical Research (CEBR), University of Genova, Genoa, Italy

    Manuela Albertelli & Diego Ferone

  7. IRCCS-AOU San Martino-IST, Genoa, Italy

    Manuela Albertelli & Diego Ferone

  8. Department of Gastroenterology, Multidisciplinary NET Center, Umbria Regional Cancer Network, Umbria, Italy

    Danilo Castellani

Authors
  1. Davide Campana
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  2. Davide Ravizza
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  3. Piero Ferolla
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  4. Antongiulio Faggiano
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  5. Franco Grimaldi
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  6. Manuela Albertelli
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  7. Debora Berretti
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  8. Danilo Castellani
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  9. Giulia Cacciari
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  10. Nicola Fazio
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  11. Annamaria Colao
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  12. Diego Ferone
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  13. Paola Tomassetti
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Correspondence to Davide Campana.

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Campana, D., Ravizza, D., Ferolla, P. et al. Clinical management of patients with gastric neuroendocrine neoplasms associated with chronic atrophic gastritis: a retrospective, multicentre study. Endocrine 51, 131–139 (2016). https://doi.org/10.1007/s12020-015-0584-z

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  • DOI: https://doi.org/10.1007/s12020-015-0584-z

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