title: Management and clinical outcomes of type I gastric carcinoid patients: retrospective, multicenter study in Japan.
abstract: OBJECTIVE
  Type I gastric carcinoids (TIGC) are associated with chronic atrophic gastritis (CAG) with hypergastrinemia and hyperplasia of enterochromaffin-like cells. Several treatment options are currently available for these tumors including total gastrectomy, partial resection, antrectomy, endoscopic resection and endoscopic surveillance. The present study evaluated different treatment approaches and clinical outcomes of patients with TIGC in Japan.
  
  
  METHODS
  Between 1991 and 2011, 82 patients with TIGC were identified at multicenter institutions in Japan. Patient demographics, tumor size, depth of invasion, vessel involvement, treatment approach, Helicobacter pylori infection, serum gastrin level, recurrence-free survival (RFS) and disease-specific survival (DSS) were analyzed.
  
  
  RESULTS
  Median age of all patients at the time of diagnosis was 56 years (range, 24-79 years). There were 44 males and 38 females. Patients underwent endoscopic surveillance (n=25), endoscopic resection (n=41) or surgical resection (n=16). Intramucosal invasion was found in 19 patients, submucosal invasion in 44 patients and muscularis propria invasion in one patient. Tumor diameter was ≤ 10 mm in 71 patients, 11-20mm in five patients and ≥ 21 mm in five patients. None of the patients showed rapidly growing tumors, local recurrence or metastasis. The median (range) follow-up period was 7(0-20) years. RFS was 97.6% and DSS was 100% in all the patients.
  
  
  CONCLUSIONS
  The prognosis of TIGC patients treated by different modalities in Japan is favorable regardless of the generational change of management for TIGC.
authors.affiliation: Department of Gastroenterology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Sato
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Imamura
authors.forename: Yasuharu
authors.initials: Y
authors.lastname: Kaizaki
authors.forename: Wasaburo
authors.initials: W
authors.lastname: Koizumi
authors.forename: Kenji
authors.initials: K
authors.lastname: Ishido
authors.forename: Koichi
authors.initials: K
authors.lastname: Kurahara
authors.forename: Haruhisa
authors.initials: H
authors.lastname: Suzuki
authors.forename: Junko
authors.initials: J
authors.lastname: Fujisaki
authors.forename: Katsuya
authors.initials: K
authors.lastname: Hirakawa
authors.forename: Osamu
authors.initials: O
authors.lastname: Hosokawa
authors.forename: Masanori
authors.initials: M
authors.lastname: Ito
authors.forename: Michio
authors.initials: M
authors.lastname: Kaminishi
authors.forename: Takahisa
authors.initials: T
authors.lastname: Furuta
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Chiba
authors.forename: Ken
authors.initials: K
authors.lastname: Haruma
mesh_terms: D000328:Adult; D000368:Aged; D002276:Carcinoid Tumor / Q000401:mortality / Q000473:pathology* / Q000601:surgery*; D015331:Cohort Studies; D005260:Female; D005743:Gastrectomy / Q000379:methods* / Q000401:mortality; D005753:Gastric Mucosa / Q000473:pathology / Q000601:surgery; D005757:Gastritis, Atrophic / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D005773:Gastroscopy / Q000379:methods; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness / Q000473:pathology; D009367:Neoplasm Staging; D011379:Prognosis; D012189:Retrospective Studies; D018570:Risk Assessment; D013274:Stomach Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery*; D015996:Survival Rate; D016896:Treatment Outcome; D055815:Young Adult
keywords: Helicobacter pylori; gastric carcinoid; type I gastric carcinoid (TIGC); type-A gastritis