Gastric neuroendocrine tumours.
BACKGROUND
Gastric neuroendocrine tumours (NETs) are increasingly recognised, and management decisions may be difficult due to an incomplete understanding of aetiology, natural history and optimum therapy. This article presents a current understanding based on recent advances in epidemiology, classification, molecular profiling, and treatment.


METHODS
Relevant medical literature was identified from searches of PubMed and references cited in appropriate articles identified. Selection of articles was based on peer review, journal and relevance.


RESULTS
Gastric NETs may be divided into three clinical prognostic groups: type I is associated with autoimmune atrophic gastritis and hypergastrinaemia, type II is associated with Zollinger-Ellison syndrome, and type III lesions are gastrin-independent, have the greatest metastatic potential and poorest prognosis. There has been an increased frequency of gastric NETs reported. Management approaches have evolved in parallel with advances in endoscopic staging and surgery, as well as improved understanding of the biology and natural history of NETs.


CONCLUSIONS
Gastric NETs present a spectrum of activity from indolent tumours to metastatic malignancy. Treatment decisions for patients must be individualised and are best managed by a multidisciplinary team approach. The current evidence base is limited to small series and efforts to treat patients within clinical networks of expertise are warranted.
Department of Surgery, Trinity Centre for Health Sciences, Trinity College Dublin/St James's Hospital, Dublin, Ireland.
David A
DA
Crosby
Claire L
CL
Donohoe
Louise
L
Fitzgerald
Cian
C
Muldoon
Brian
B
Hayes
Dermot
D
O'Toole
John V
JV
Reynolds
D000465:Algorithms; D005743:Gastrectomy; D014943:Global Health; D006801:Humans; D015994:Incidence; D007494:Ireland / Q000453:epidemiology; D009367:Neoplasm Staging; D018358:Neuroendocrine Tumors / Q000145:classification / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D011379:Prognosis; D012307:Risk Factors; D013274:Stomach Neoplasms / Q000145:classification / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D016896:Treatment Outcome; D015043:Zollinger-Ellison Syndrome / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy