Metastatic type 1 gastric carcinoid: a real threat or just a myth?

Abstract

AIM:

To describe disease characteristics and treatment modalities in a group of rare patients with metastatic gastric carcinoid type 1 (GCA1).

METHODS:

Information on clinical, biochemical, radiological, histopathological findings, the extent of the disease, as well as the use of different therapeutic modalities and the long-term outcome were recorded. Patients' data were assessed at presentation, and thereafter at 6 to 12 monthly intervals both clinically and biochemically, but also endoscopically and histopathologically. Patients were evaluated for the presence of specific symptoms; the presence of autoimmune disorders and the presence of other gastrointestinal malignancies in other family members were also recorded. The evaluation of response to treatment was defined using established WHO criteria.

RESULTS:

We studied twenty consecutive patients with a mean age of 55.1 years. The mean follow-up period was 83 mo. Twelve patients had regional lymph node metastases and 8 patients had liver metastases. The primary tumor mean diameter was 20.13 ± 10.83 mm (mean ± SD). The mean Ki-67 index was 6.8% ± 11.2%. All but one patient underwent endoscopic or surgical excision of the tumor. The disease was stable in all but 3 patients who had progressive liver disease. All patients remained alive during the follow-up period.

CONCLUSION:

Metastatic GCA1 carries a good overall prognosis, being related to a tumor size of ≥ 1 cm, an elevated Ki-67 index and high serum gastrin levels.

• Authors: Simona Grozinsky-Glasberg, Dimitrios Thomas, Jonathan R Strosberg, Ulrich-Frank Pape, Stephan Felder, Apostolos V Tsolakis, Krystallenia I Alexandraki, Merav Fraenkel, Leonard Saiegh, Petachia Reissman, Gregory Kaltsas, David J Gross
• Journal: World journal of gastroenterology (World J Gastroenterol) Vol. 19 Issue 46 Pg. 8687-95 (Dec 14 2013) ISSN: 2219-2840 [Electronic] United States
• PMID: 24379587 (Publication Type: Journal Article, Multicenter Study)

Chemical References

• Gastrins
• Ki-67 Antigen

Topics

• Adult
• Aged
• Carcinoid Tumor (blood, chemistry, classification, secondary, therapy)
• Chemotherapy, Adjuvant
• Disease Progression
• Europe
• Female
• Gastrectomy
• Gastric Bypass
• Gastrins (blood)
• Gastroscopy
• Humans
• Israel
• Ki-67 Antigen (analysis)
• Liver Neoplasms (classification, secondary, therapy)
• Lymph Node Excision
• Lymphatic Metastasis
• Male
• Middle Aged
• Multimodal Imaging
• Positron-Emission Tomography
• Retrospective Studies
• Stomach Neoplasms (blood, chemistry, classification, pathology, therapy)
• Time Factors
• Tomography, X-Ray Computed
• Treatment Outcome
• Tumor Burden