Management and Disease Outcome of Type I Gastric Neuroendocrine Tumors: The Mount Sinai Experience

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• 作者：William C. Chen ; Richard R. P. Warner ; Stephen C. Ward…
• 关键词：Type I gastric NET ; Neuroendocrine tumor ; Gastric carcinoid ; Stomach
• 刊名：Digestive Diseases and Sciences
• 出版年：2015
• 出版时间：April 2015
• 年：2015
• 卷：60
• 期：4
• 页码：996-1003
• 全文大小：570 KB
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• 作者单位：William C. Chen (1) (4)
  Richard R. P. Warner (1) (5)
  Stephen C. Ward (3) (6)
  Noam Harpaz (1) (3) (7)
  Celia M. Divino (2) (8)
  Steven H. Itzkowitz (1) (9)
  Michelle K. Kim (1) (9)
  
  1. Division of Gastroenterology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
  4. 50 East 98th Street, Apt 8A, New York, NY, 10029, USA
  5. 5 East 98th Street, 11th Floor, New York, NY, 10029, USA
  3. Division of Gastrointestinal Pathology, Department of Pathology, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
  6. Annenberg Building 15th Floor, Room 92, 1468 Madison Avenue, New York, NY, 10029, USA
  7. Annenberg Building 15th Floor, Room 38, 1468 Madison Avenue, New York, NY, 10029, USA
  2. Division of General Surgery, Department of Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
  8. 5 East 98th Street, 14th Floor, Suite A, New York, NY, 10029, USA
  9. One Gustave L. Levy Place, Box 1069, New York, NY, 10029, USA
  
• 刊物类别：Medicine
• 刊物主题：Medicine & Public Health
  Gastroenterology
  Hepatology
  Oncology
  Transplant Surgery
  Biochemistry
  
• 出版者：Springer Netherlands
• ISSN：1573-2568

文摘

Background and Aim The incidence of gastric neuroendocrine tumors (NETs) has increased tenfold since the 1970s. Our aim was to describe the clinicopathologic profile, management, and outcomes of type I gastric NETs at The Mount Sinai Hospital. Methods From existing databases of the Mount Sinai Division of Gastrointestinal Pathology and the Carcinoid Cancer Foundation, we identified 56 patients with type I gastric NETs seen at The Mount Sinai Hospital from 1993 to 2012. We generated a comprehensive dataset encompassing demographic, clinical, endoscopic, and pathologic factors. Survival information was determined from medical records and the Social Security Death Index. Tumor–node–metastasis staging was conducted, and tumors were graded based on mitotic counts and Ki67 index. Results Median NET size was 3.0?mm; 55.8?% displayed multifocal disease. Stages I, II, III, and IV disease were observed in 83.8, 10.8, 5.4, and 0?%, respectively. Tumors were either low (69.7?%) or intermediate (30.3?%) grade. Furthermore, 3.6?% of patients developed gastric dysplasia, and 5.5?% had gastric adenocarcinoma. Patients underwent endoscopy every 15?months, while 28.6?% underwent polypectomy, 32.7?% somatostatin therapy, and 46.4?% surgical resection. 5- and 10-year disease-specific survival was 100?%. Conclusions Most patients received annual endoscopic surveillance, with a minority undergoing surgical resection, though outcomes remained excellent independent of therapeutic approach. We identified a very low but real rate of loco-regional spread, despite the generally indolent behavior of type I gastric NETs. Several patients demonstrated concurrent dysplasia or adenocarcinoma, underscoring the efficacy of regular endoscopic management not only for gastric NETs, but also for dysplasia and adenocarcinoma.