title: Long-term follow-up of a large series of patients with type 1 gastric carcinoid tumors: data from a multicenter study.
abstract: OBJECTIVE
  To study the clinical presentation, diagnostic approach, response to treatment, and the presence of other pathologies in patients with gastric carcinoid type 1 (GC 1) tumors.
  
  
  METHODS
  Retrospective analysis of 111 patients from four institutions and a mean follow-up of 76 months.
  
  
  RESULTS
  The main indications for gastroscopy were upper gastrointestinal tract symptoms. The mean number of lesions, maximum tumoral diameter, and percentage of cells expressing Ki-67 labeling index were 3.6±3.8, 8±12.1 mm and 1.9±2.4% respectively. Serum gastrin and chromogranin A (CgA) levels were elevated in 100/101 and 85/90 patients respectively. Conventional imaging studies demonstrated pathology in 9/111 patients. Scintigraphy with radiolabeled octreotide was positive in 6/60 without revealing any additional lesions. From the 59 patients who had been followed-up without any intervention, five developed tumor progression. Thirty-two patients were treated with long-acting somatostatin analogs (SSAs), leading to a significant reduction of gastrin and CgA levels, number of visible tumors, and CgA immune-reactive tumor cells in 28, 19, 27, and 23 treated patients respectively. Antrectomy and/or gastrectomy were initially performed in 20 patients and a complete response was achieved in 13 patients. The most common comorbidities were vitamin B12 deficiency, thyroiditis, and parathyroid adenomas.
  
  
  CONCLUSIONS
  Most GCs1 are grade 1 (82.7%) tumors presenting with stage I (73.9%) disease with no mortality after prolonged follow-up. Ocreoscan did not provide further information compared with conventional imaging techniques. Treatment with SSAs proved to be effective for the duration of administration.
authors.affiliation: Department of Pathophysiology, National University of Athens, Mikras Asias 75, 11557 Athens, Greece. thomasproge@endo.gr
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Thomas
authors.forename: Apostolos V
authors.initials: AV
authors.lastname: Tsolakis
authors.forename: Simona
authors.initials: S
authors.lastname: Grozinsky-Glasberg
authors.forename: Merav
authors.initials: M
authors.lastname: Fraenkel
authors.forename: Krystallenia
authors.initials: K
authors.lastname: Alexandraki
authors.forename: Stavros
authors.initials: S
authors.lastname: Sougioultzis
authors.forename: David J
authors.initials: DJ
authors.lastname: Gross
authors.forename: Gregory
authors.initials: G
authors.lastname: Kaltsas
mesh_terms: D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use*; D014408:Biomarkers, Tumor / Q000097:blood; D002276:Carcinoid Tumor / Q000097:blood / Q000188:drug therapy / Q000473:pathology*; D053379:Chromogranin A / Q000097:blood; D005260:Female; D005500:Follow-Up Studies; D005755:Gastrins / Q000097:blood; D006801:Humans; D008297:Male; D015282:Octreotide / Q000627:therapeutic use*; D011379:Prognosis; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000097:blood / Q000188:drug therapy / Q000473:pathology*; D016896:Treatment Outcome
chemical_list: D018931:Antineoplastic Agents, Hormonal; D014408:Biomarkers, Tumor; D053379:Chromogranin A; D005755:Gastrins; D015282:Octreotide