Type 1 gastric carcinoids: Efficacy and safety of endoscopic management.

Abstract

e14577 Background: Type I gastric carcinoids (TIGC) are “rare” neuroendocrine neoplasms arising from ECL cells in the background of atrophic body gastritis, due to gastrin growth effects. Diagnosis is often accidental, as patients may be asymptomatic, and these tumors are usually indolent. Data regarding their evolution in prospective series are scanty, and thus treatment and follow-up programs are not codified. Our aim was to assess clinical outcome and recurrence in a series of TIGC patients managed by endoscopic approach. Methods: We enrolled in this prospective study consecutive patients with TIGC (diagnosis of gastric well-differentiated endocrine tumor associated with atrophic body gastritis) who had at least one gastroscopy after the first diagnosis. Exclusion criteria were treatments other than endoscopical resection (polypectomy or mucosectomy). Results: 33 patients (24 females), median age 65 (23-81), 75.7% with anemia (40% pernicious). 7 tumors (22.2%) were microcarcinoids, 26 polyps (median diameter: 5 mm; 2-20) multiple in 17 (65.4%) patients. Associated severe atrophy in 21 cases (63.6%), mild in 18.2%. During 46-month median follow-up, survival was 100% and no local/distant invasion occurred. 21 patients (63.6%) had recurrence after a median of 8 months, 12 of these (57.1%) had second recurrence after a median of 7 months from previous TIGC removal. Median recurrence-free survival was 15 months. Nor clinical neither biochemical factors predicting for recurrence were found. Conclusions: Although about 60% of TIGC patients underwent recurrence after endoscopic resection, no tumor progression was observed during follow-up. In patients with TIGC, endoscopic management may be considered safe and effective, while radiological stadiation is not mandatory. No significant financial relationships to disclose.