Presentation, treatment, and outcome of type 1 gastric carcinoid tumors

J Surg Oncol. 2006 Apr 1;93(5):368-72. doi: 10.1002/jso.20468.

Abstract

Background and objectives: The aim of this study was to review the presentation, treatment, and outcome of patients with Type 1 gastric carcinoid tumors.

Methods: A retrospective review of 1,600 carcinoid patients was analyzed to identify patients with gastric carcinoid tumors.

Results: Eighteen patients were found to have biopsy-confirmed Type 1 gastric carcinoid tumors on upper endoscopy. Reasons for endoscopy included abdominal pain (n = 4), gastrointestinal bleeding (n = 4), surveillance for pernicious anemia (n = 8), and other (n = 2). The mean pre-treatment serum gastrin and chromogranin A levels were 1,436 ng/ml (+/-771 ng/ml) and 91.6 ng/ml (+/-68.6 ng/ml), respectively. Imaging revealed evidence of gastric carcinoid in 4 of 10 patients undergoing CT scanning and 3 of 10 patients undergoing octreotide scintigraphy. Of the 18 patients, 8 were treated medically (acidification or octreotide) and 10 were treated with surgery (laparoscopic antrectomy or partial gastrectomy). Mean gastrin levels decreased by 37.2% in the medically treated group (median follow-up 6 months), versus 94.0% in the surgically treated patients (median follow-up 5 months). Mean chromogranin A levels decreased by 56.2% in patients undergoing surgery.

Conclusions: Gastric antrectomy is the most efficacious treatment for Type 1 gastric carcinoid, leading to a significant reduction in serum gastrin levels and regression of carcinoid tumors.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Antineoplastic Agents, Hormonal / therapeutic use
  • Biomarkers, Tumor / blood
  • Carcinoid Tumor* / diagnosis
  • Carcinoid Tumor* / drug therapy
  • Carcinoid Tumor* / surgery
  • Chromogranin A
  • Chromogranins / blood
  • Enterochromaffin-like Cells / pathology
  • Female
  • Gastrectomy
  • Gastrins / antagonists & inhibitors
  • Gastrins / blood
  • Humans
  • Male
  • Middle Aged
  • Octreotide / therapeutic use
  • Pyloric Antrum / surgery
  • Retrospective Studies
  • Somatostatin / therapeutic use
  • Stomach Neoplasms* / diagnosis
  • Stomach Neoplasms* / drug therapy
  • Stomach Neoplasms* / surgery
  • Treatment Outcome

Substances

  • Antineoplastic Agents, Hormonal
  • Biomarkers, Tumor
  • Chromogranin A
  • Chromogranins
  • Gastrins
  • Somatostatin
  • Octreotide