Presentation, treatment, and outcome of type 1 gastric carcinoid tumors.
OBJECTIVE
The aim of this study was to review the presentation, treatment, and outcome of patients with Type 1 gastric carcinoid tumors.


METHODS
A retrospective review of 1,600 carcinoid patients was analyzed to identify patients with gastric carcinoid tumors.


RESULTS
Eighteen patients were found to have biopsy-confirmed Type 1 gastric carcinoid tumors on upper endoscopy. Reasons for endoscopy included abdominal pain (n = 4), gastrointestinal bleeding (n = 4), surveillance for pernicious anemia (n = 8), and other (n = 2). The mean pre-treatment serum gastrin and chromogranin A levels were 1,436 ng/ml (+/-771 ng/ml) and 91.6 ng/ml (+/-68.6 ng/ml), respectively. Imaging revealed evidence of gastric carcinoid in 4 of 10 patients undergoing CT scanning and 3 of 10 patients undergoing octreotide scintigraphy. Of the 18 patients, 8 were treated medically (acidification or octreotide) and 10 were treated with surgery (laparoscopic antrectomy or partial gastrectomy). Mean gastrin levels decreased by 37.2% in the medically treated group (median follow-up 6 months), versus 94.0% in the surgically treated patients (median follow-up 5 months). Mean chromogranin A levels decreased by 56.2% in patients undergoing surgery.


CONCLUSIONS
Gastric antrectomy is the most efficacious treatment for Type 1 gastric carcinoid, leading to a significant reduction in serum gastrin levels and regression of carcinoid tumors.
Department of Surgery, Weill Medical College of Cornell University, New York, NY, USA.
Gregory F
GF
Dakin
Richard R P
RR
Warner
Alfons
A
Pomp
Barry
B
Salky
William B
WB
Inabnet
D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use; D014408:Biomarkers, Tumor / Q000097:blood; D002276:Carcinoid Tumor / Q000175:diagnosis / Q000188:drug therapy / Q000601:surgery; D053379:Chromogranin A; D002864:Chromogranins / Q000097:blood; D019861:Enterochromaffin-like Cells / Q000473:pathology; D005260:Female; D005743:Gastrectomy; D005755:Gastrins / Q000037:antagonists & inhibitors / Q000097:blood; D006801:Humans; D008297:Male; D008875:Middle Aged; D015282:Octreotide / Q000627:therapeutic use; D011706:Pyloric Antrum / Q000601:surgery; D012189:Retrospective Studies; D013004:Somatostatin / Q000627:therapeutic use; D013274:Stomach Neoplasms / Q000175:diagnosis / Q000188:drug therapy / Q000601:surgery; D016896:Treatment Outcome
D018931:Antineoplastic Agents, Hormonal; D014408:Biomarkers, Tumor; D053379:Chromogranin A; D002864:Chromogranins; D005755:Gastrins; D013004:Somatostatin; D015282:Octreotide