Long-term results of endoscopic resection for type I gastric neuroendocrine tumors

J Surg Oncol. 2014 Feb;109(2):71-4. doi: 10.1002/jso.23477. Epub 2013 Oct 25.

Abstract

Background: A number of different therapies, including endoscopic resection, have been suggested for the treatment of Type 1 gastric neuroendocrine tumors (NETs). The current study aimed to determine the long-term efficacy of endoscopic resection for Type 1 gastric NETs.

Methods: Twenty-two patients (from 1999 to 2012) with Type 1 gastric NETs were included in the study. All patients were treated with endoscopic resection and received regular followed-up appointments at a tertiary referral center.

Results: All patients were initially diagnosed with hypergastrinemia, atrophic gastritis and intestinal metaplasia. Polyps' diameters were >1 cm in 4 patients, and between 0.5 and 1 cm in 18 patients. All detectable lesions were successfully resected. One patient required surgery due to gastric perforation during endoscopic mucosal resection. Recurrence was detected in four patients (18%) and endoscopic resection was performed again. Local or distant metastasis was not observed in any patient during follow-up. Median follow-up time was 7 years, with a maximum of 14 years. Seventeen patients (78%) completed a 5-year follow-up period, and overall disease-free survival rate was 100%.

Conclusions: Long-term follow-ups with 22 patients suggest that endoscopic resection of Type 1 gastric NETs is a safe and effective treatment option with a relatively low recurrence rate.

Keywords: endoscopic mucosectomy; gastric carcinoid; neuroendocrine tumors.

MeSH terms

  • Adult
  • Aged
  • Chromogranin A / blood
  • Disease-Free Survival
  • Female
  • Follow-Up Studies
  • Gastric Mucosa / surgery
  • Gastrins / blood
  • Gastroscopy*
  • Humans
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local
  • Neuroendocrine Tumors / classification
  • Neuroendocrine Tumors / mortality
  • Neuroendocrine Tumors / pathology
  • Neuroendocrine Tumors / surgery*
  • Polyps / pathology
  • Polyps / surgery*
  • Prospective Studies
  • Reoperation
  • Stomach Neoplasms / mortality
  • Stomach Neoplasms / pathology
  • Stomach Neoplasms / surgery*

Substances

  • Chromogranin A
  • Gastrins