title: Type I gastric carcinoids: a prospective study on endoscopic management and recurrence rate.
abstract: BACKGROUND
  Type I gastric carcinoids (TIGCs) are neuroendocrine neoplasms arising from enterochromaffin-like cells in atrophic body gastritis. Data regarding their evolution in prospective series are scarce, thus treatment and follow-up are not codified. Our aim was to evaluate clinical outcome and recurrence in TIGCs managed by endoscopic approach.
  
  
  METHODS
  33 patients (24 females; median age 65 years, range 23-81) were included and managed through endoscopic follow-up every 6-12 months, with lesion removal and multiple gastric biopsies. Baseline clinical and histological features were analyzed as risk factors by Cox regression.
  
  
  RESULTS
  At diagnosis, 7 tumors were intramucosal carcinoids and 26 were polyps (median diameter 5 mm, range 2-20), multiple in 17 patients. Associated severe atrophy was present in 21 cases (63.6%), while mild atrophy was found in 6 cases (18.2%). During a 46-month median follow-up, survival was 100% and no metastases occurred. One patient developed a less-differentiated carcinoid that was radically treated by surgery. 21 patients (63.6%) had recurrence after a median of 8 months, 14 of these (66.6%) had a second recurrence after a median of 8 months following the previous carcinoid removal. Median recurrence-free survival was 24 months. Neither clinical nor biochemical recurrence-predicting factors were found.
  
  
  CONCLUSIONS
  Although about 60% of TIGCs had recurrence after endoscopic resection, endoscopic management may be considered safe and effective.
authors.affiliation: Department of Digestive and Liver Disease, Sant'Andrea Hospital, II Medical School, Sapienza University of Rome, Rome, Italy.
authors.forename: Elettra
authors.initials: E
authors.lastname: Merola
authors.forename: Andrea
authors.initials: A
authors.lastname: Sbrozzi-Vanni
authors.forename: Francesco
authors.initials: F
authors.lastname: Panzuto
authors.forename: Giancarlo
authors.initials: G
authors.lastname: D'Ambra
authors.forename: Emilio
authors.initials: E
authors.lastname: Di Giulio
authors.forename: Emanuela
authors.initials: E
authors.lastname: Pilozzi
authors.forename: Gabriele
authors.initials: G
authors.lastname: Capurso
authors.forename: Edith
authors.initials: E
authors.lastname: Lahner
authors.forename: Cesare
authors.initials: C
authors.lastname: Bordi
authors.forename: Bruno
authors.initials: B
authors.lastname: Annibale
authors.forename: Gianfranco
authors.initials: G
authors.lastname: Delle Fave
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002276:Carcinoid Tumor / Q000601:surgery*; D004724:Endoscopy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D005757:Gastritis, Atrophic; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000517:prevention & control; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors; D013274:Stomach Neoplasms / Q000601:surgery*; D015996:Survival Rate; D016896:Treatment Outcome; D055815:Young Adult