Management and clinical outcomes of type I gastric carcinoid patients: retrospective, multicenter study in Japan.
BACKGROUND AND AIM
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.


CONCLUSION
The prognosis of TIGC patients treated by different modalities in Japan is favorable regardless of the generational change of management for TIGC.
['Sato|Yuichi|Y|', 'Imamura|Hiroshi|H|', 'Kaizaki|Yasuharu|Y|', 'Koizumi|Wasaburo|W|', 'Ishido|Kenji|K|', 'Kurahara|Koichi|K|', 'Suzuki|Haruhisa|H|', 'Fujisaki|Junko|J|', 'Hirakawa|Katsuya|K|', 'Hosokawa|Osamu|O|', 'Ito|Masanori|M|', 'Kaminishi|Michio|M|', 'Furuta|Takahisa|T|', 'Chiba|Tsutomu|T|', 'Haruma|Ken|K|']
D000328:Adult D000368:Aged D002276:Carcinoid Tumor D015331:Cohort Studies D005260:Female D005743:Gastrectomy D005753:Gastric Mucosa D005757:Gastritis, Atrophic D005773:Gastroscopy D006801:Humans D007564:Japan D008297:Male D008875:Middle Aged D009361:Neoplasm Invasiveness D009367:Neoplasm Staging D011379:Prognosis D012189:Retrospective Studies D018570:Risk Assessment D013274:Stomach Neoplasms D015996:Survival Rate D016896:Treatment Outcome D055815:Young Adult
gastric carcinoid type I gastric carcinoid (TIGC) Helicobacter pylori type-A gastritis