title: Clinical management of patients with gastric neuroendocrine neoplasms associated with chronic atrophic gastritis: a retrospective, multicentre study.
abstract: To provide data regarding clinical presentation, pathological features, management, and response to different treatments of patients with type I gastric neuroendocrine tumors in stages 0-2A. The study design consist of an Italian multicentre, retrospective analysis of patients with type I gastric neuroendocrine tumors managed with different therapeutic approaches: surgery, endoscopic surveillance, endoscopic resection, or somatostatin analog therapy. Among the 97 patients included, 3 underwent surgery, 45 (46.4%) radical endoscopic resection of the neoplastic lesions, 13 (13.4%) follow-up with upper endoscopy, and 36 (37.1%) somatostatin analog therapy. At the end of the follow-up, all patients were alive and there was no evidence of metastatic disease. Somatostatin analog therapy resulted in a complete response in 76.0% of the patients and stable disease in 24.0%. A prolonged period of therapy, the use of a full dose of somatostatin analogs and higher gastrin levels at diagnosis were related to a complete response to the therapy. The recurrence rate was 26.3% in patients treated with somatostatin analog therapy and 26.2% in patients treated with endoscopic resection, without a statistically significant difference in terms of disease-free survival. Regarding recurrence of the disease, no statistical difference was found according to type of therapy, number of neoplastic lesions, and 2010 WHO classification. The only risk factor for tumor recurrence was a short period of medical treatment. In conclusion, our study suggested that endoscopic surveillance, endoscopic resection and somatostatin analog therapy represent valid options in the management of patients with type I gastric neuroendocrine tumors in stages 0-2A.
authors: Department of Medical and Surgical Sciences, S.Orsola-Malpighi University Hospital, University of Bologna, Via Massarenti, 9, 40138, Bologna, Italy. davide.campana@unibo.it.
authors: Davide
authors: D
authors: Campana
authors: Division of Endoscopy and Unit of Gastrointestinal and Neuroendocrine Tumours, European Institute of Oncology, Milan, Italy.
authors: Davide
authors: D
authors: Ravizza
authors: Department of Medical Oncology, Multidisciplinary NET Center, Umbria Regional Cancer Network, Umbria, Italy.
authors: Piero
authors: P
authors: Ferolla
authors: Division of Endocrinology, Department of Clinical Medicine and Surgery, "Federico II" University of Naples, Naples, Italy.
authors: Antongiulio
authors: A
authors: Faggiano
authors: Endocrinology and Metabolism Unit, University Hospital S. Maria della Misericordia, Udine, Italy.
authors: Franco
authors: F
authors: Grimaldi
authors: Endocrinology, Department of Internal Medicine and Medical Specialties (DiMI) and Center of Excellence for Biomedical Research (CEBR), University of Genova, Genoa, Italy.|IRCCS-AOU San Martino-IST, Genoa, Italy.
authors: Manuela
authors: M
authors: Albertelli
authors: Endocrinology and Metabolism Unit, University Hospital S. Maria della Misericordia, Udine, Italy.
authors: Debora
authors: D
authors: Berretti
authors: Department of Gastroenterology, Multidisciplinary NET Center, Umbria Regional Cancer Network, Umbria, Italy.
authors: Danilo
authors: D
authors: Castellani
authors: Department of Medical and Surgical Sciences, S.Orsola-Malpighi University Hospital, University of Bologna, Via Massarenti, 9, 40138, Bologna, Italy.
authors: Giulia
authors: G
authors: Cacciari
authors: Division of Endoscopy and Unit of Gastrointestinal and Neuroendocrine Tumours, European Institute of Oncology, Milan, Italy.
authors: Nicola
authors: N
authors: Fazio
authors: Division of Endocrinology, Department of Clinical Medicine and Surgery, "Federico II" University of Naples, Naples, Italy.
authors: Annamaria
authors: A
authors: Colao
authors: Endocrinology, Department of Internal Medicine and Medical Specialties (DiMI) and Center of Excellence for Biomedical Research (CEBR), University of Genova, Genoa, Italy.|IRCCS-AOU San Martino-IST, Genoa, Italy.
authors: Diego
authors: D
authors: Ferone
authors: Department of Medical and Surgical Sciences, S.Orsola-Malpighi University Hospital, University of Bologna, Via Massarenti, 9, 40138, Bologna, Italy.
authors: Paola
authors: P
authors: Tomassetti
mesh_terms: D000368:Aged; D002276:Carcinoid Tumor / Q000150:complications / Q000453:epidemiology / Q000628:therapy; D002908:Chronic Disease; D005260:Female; D005757:Gastritis, Atrophic / Q000150:complications / Q000453:epidemiology / Q000628:therapy*; D005773:Gastroscopy / Q000706:statistics & numerical data; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D018358:Neuroendocrine Tumors / Q000150:complications / Q000453:epidemiology / Q000628:therapy*; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000150:complications / Q000453:epidemiology / Q000628:therapy*
keywords: Chronic atrophic gastritis; Endoscopic resection; Gastric carcinoid; Neuroendocrine tumors; Somatostatin analogs