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Review article: the investigation and management of gastric neuroendocrine tumours
Summary Background Gastric carcinoids (GCs) or neuroendocrine tumours (NETs) are increasingly identified at endoscopy, and account for 0.6–2% of all gastric polyps identified. The SEER database in the US has demonstrated a rising incidence of gastric NETs amongst all NETs; from 2.2% between 1950 and...
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| Published in: | Alimentary pharmacology & therapeutics 2014-05, Vol.39 (10), p.1071-1084 |
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| Main Authors: | , , , , |
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| cites | cdi_FETCH-LOGICAL-c3558-9d01d04141294cfa16f6c1eab6d4b7d23e7e38c1f886f4d4ed8621f129439cc53 |
| container_end_page | 1084 |
| container_issue | 10 |
| container_start_page | 1071 |
| container_title | Alimentary pharmacology & therapeutics |
| container_volume | 39 |
| creator | Basuroy, R. Srirajaskanthan, R. Prachalias, A. Quaglia, A. Ramage, J. K. |
| description | Summary
Background
Gastric carcinoids (GCs) or neuroendocrine tumours (NETs) are increasingly identified at endoscopy, and account for 0.6–2% of all gastric polyps identified. The SEER database in the US has demonstrated a rising incidence of gastric NETs amongst all NETs; from 2.2% between 1950 and 1969 to 6.0% between 2000 and 2007.
Aim
To review the literature and assist clinicians in managing patients with GCs.
Methods
A literature search was conducted through MEDLINE using search terms: gastric, carcinoid, neuroendocrine tumour, therapy, endoscopy, mucosal resection, submucosal dissection. Relevant articles were identified through manual review. The reference lists of these articles were reviewed to include further appropriate articles.
Results
There are three types of GCs with important epidemiological, pathophysiological, histological and endoscopic differences that affect prognosis and management. Type 1 and 2 GCs develop in the context of hypergastrinaemia that originates from achlorhydria in atrophic gastritis and a gastrinoma, respectively. Type 3 GCs occur sporadically and independent of gastrin. The histological type, grade and Ki67 index are used to determine prognosis and direct clinical management. Type 1 GCs >1 cm in size and type 2 GCs should be assessed for invasion beyond the submucosa with EUS prior to endoscopic resection with EMR or ESD. Type 3 GCs should be managed as per recommendations for gastric adenocarcinoma. The treatment of advanced disease is multimodal.
Conclusions
Patients with gastric carcinoids should be discussed in a specialist neuroendocrine tumour multidisciplinary meeting to ensure all treatment options are explored in localised and advanced disease. Areas of controversy exist that need further research. |
| doi_str_mv | 10.1111/apt.12698 |
| format | article |
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Background
Gastric carcinoids (GCs) or neuroendocrine tumours (NETs) are increasingly identified at endoscopy, and account for 0.6–2% of all gastric polyps identified. The SEER database in the US has demonstrated a rising incidence of gastric NETs amongst all NETs; from 2.2% between 1950 and 1969 to 6.0% between 2000 and 2007.
Aim
To review the literature and assist clinicians in managing patients with GCs.
Methods
A literature search was conducted through MEDLINE using search terms: gastric, carcinoid, neuroendocrine tumour, therapy, endoscopy, mucosal resection, submucosal dissection. Relevant articles were identified through manual review. The reference lists of these articles were reviewed to include further appropriate articles.
Results
There are three types of GCs with important epidemiological, pathophysiological, histological and endoscopic differences that affect prognosis and management. Type 1 and 2 GCs develop in the context of hypergastrinaemia that originates from achlorhydria in atrophic gastritis and a gastrinoma, respectively. Type 3 GCs occur sporadically and independent of gastrin. The histological type, grade and Ki67 index are used to determine prognosis and direct clinical management. Type 1 GCs >1 cm in size and type 2 GCs should be assessed for invasion beyond the submucosa with EUS prior to endoscopic resection with EMR or ESD. Type 3 GCs should be managed as per recommendations for gastric adenocarcinoma. The treatment of advanced disease is multimodal.
Conclusions
Patients with gastric carcinoids should be discussed in a specialist neuroendocrine tumour multidisciplinary meeting to ensure all treatment options are explored in localised and advanced disease. Areas of controversy exist that need further research.</description><identifier>ISSN: 0269-2813</identifier><identifier>EISSN: 1365-2036</identifier><identifier>DOI: 10.1111/apt.12698</identifier><identifier>PMID: 24628514</identifier><language>eng</language><publisher>Oxford: Blackwell</publisher><subject>Biological and medical sciences ; Dissection - methods ; Endoscopy - methods ; Gastrins ; Gastritis, Atrophic - pathology ; Gastritis, Atrophic - therapy ; Gastroenterology. Liver. Pancreas. Abdomen ; Humans ; Medical sciences ; Neuroendocrine Tumors - diagnosis ; Neuroendocrine Tumors - pathology ; Neuroendocrine Tumors - therapy ; Polyps - pathology ; Prognosis ; Stomach Neoplasms - diagnosis ; Stomach Neoplasms - pathology ; Stomach Neoplasms - therapy ; Stomach. Duodenum. Small intestine. Colon. Rectum. Anus ; Tumors</subject><ispartof>Alimentary pharmacology & therapeutics, 2014-05, Vol.39 (10), p.1071-1084</ispartof><rights>2014 John Wiley & Sons Ltd</rights><rights>2015 INIST-CNRS</rights><rights>2014 John Wiley & Sons Ltd.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3558-9d01d04141294cfa16f6c1eab6d4b7d23e7e38c1f886f4d4ed8621f129439cc53</citedby><cites>FETCH-LOGICAL-c3558-9d01d04141294cfa16f6c1eab6d4b7d23e7e38c1f886f4d4ed8621f129439cc53</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fapt.12698$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fapt.12698$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>315,786,790,27957,27958,50923,51032</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=28415360$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/24628514$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Basuroy, R.</creatorcontrib><creatorcontrib>Srirajaskanthan, R.</creatorcontrib><creatorcontrib>Prachalias, A.</creatorcontrib><creatorcontrib>Quaglia, A.</creatorcontrib><creatorcontrib>Ramage, J. K.</creatorcontrib><title>Review article: the investigation and management of gastric neuroendocrine tumours</title><title>Alimentary pharmacology & therapeutics</title><addtitle>Aliment Pharmacol Ther</addtitle><description>Summary
Background
Gastric carcinoids (GCs) or neuroendocrine tumours (NETs) are increasingly identified at endoscopy, and account for 0.6–2% of all gastric polyps identified. The SEER database in the US has demonstrated a rising incidence of gastric NETs amongst all NETs; from 2.2% between 1950 and 1969 to 6.0% between 2000 and 2007.
Aim
To review the literature and assist clinicians in managing patients with GCs.
Methods
A literature search was conducted through MEDLINE using search terms: gastric, carcinoid, neuroendocrine tumour, therapy, endoscopy, mucosal resection, submucosal dissection. Relevant articles were identified through manual review. The reference lists of these articles were reviewed to include further appropriate articles.
Results
There are three types of GCs with important epidemiological, pathophysiological, histological and endoscopic differences that affect prognosis and management. Type 1 and 2 GCs develop in the context of hypergastrinaemia that originates from achlorhydria in atrophic gastritis and a gastrinoma, respectively. Type 3 GCs occur sporadically and independent of gastrin. The histological type, grade and Ki67 index are used to determine prognosis and direct clinical management. Type 1 GCs >1 cm in size and type 2 GCs should be assessed for invasion beyond the submucosa with EUS prior to endoscopic resection with EMR or ESD. Type 3 GCs should be managed as per recommendations for gastric adenocarcinoma. The treatment of advanced disease is multimodal.
Conclusions
Patients with gastric carcinoids should be discussed in a specialist neuroendocrine tumour multidisciplinary meeting to ensure all treatment options are explored in localised and advanced disease. Areas of controversy exist that need further research.</description><subject>Biological and medical sciences</subject><subject>Dissection - methods</subject><subject>Endoscopy - methods</subject><subject>Gastrins</subject><subject>Gastritis, Atrophic - pathology</subject><subject>Gastritis, Atrophic - therapy</subject><subject>Gastroenterology. Liver. Pancreas. Abdomen</subject><subject>Humans</subject><subject>Medical sciences</subject><subject>Neuroendocrine Tumors - diagnosis</subject><subject>Neuroendocrine Tumors - pathology</subject><subject>Neuroendocrine Tumors - therapy</subject><subject>Polyps - pathology</subject><subject>Prognosis</subject><subject>Stomach Neoplasms - diagnosis</subject><subject>Stomach Neoplasms - pathology</subject><subject>Stomach Neoplasms - therapy</subject><subject>Stomach. Duodenum. Small intestine. Colon. Rectum. Anus</subject><subject>Tumors</subject><issn>0269-2813</issn><issn>1365-2036</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><recordid>eNp10E1rGzEQBmARWhLHySF_oOhSaA5rayStrO0tmOYDAg0hOS-yNHJVdrWutBuTf9917DSnzmVgeJgZXkIugM1grLnZ9DPgqtJHZAJClQVnQn0iEzbOCq5BnJDTnH8zxtSC8WNywqXiugQ5IY-P-BJwS03qg23wO-1_IQ3xBXMf1qYPXaQmOtqaaNbYYuxp5-na5D4FSyMOqcPoOptCRNoPbTekfEY-e9NkPD_0KXm-_vG0vC3uf97cLa_uCyvKUheVY-CYBAm8ktYbUF5ZQLNSTq4WjgtcoNAWvNbKSyfRacXB77SorC3FlHzb792k7s8wPly3IVtsGhOxG3INJSxEVQGIkV7uqU1dzgl9vUmhNem1BlbvIqzHCOu3CEf75bB2WLXo_sn3zEbw9QBMtqbxyUQb8ofTEkqh2Ojme7cNDb7-_2J99fC0P_0X9R2ITA</recordid><startdate>201405</startdate><enddate>201405</enddate><creator>Basuroy, R.</creator><creator>Srirajaskanthan, R.</creator><creator>Prachalias, A.</creator><creator>Quaglia, A.</creator><creator>Ramage, J. K.</creator><general>Blackwell</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>201405</creationdate><title>Review article: the investigation and management of gastric neuroendocrine tumours</title><author>Basuroy, R. ; Srirajaskanthan, R. ; Prachalias, A. ; Quaglia, A. ; Ramage, J. K.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3558-9d01d04141294cfa16f6c1eab6d4b7d23e7e38c1f886f4d4ed8621f129439cc53</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>Biological and medical sciences</topic><topic>Dissection - methods</topic><topic>Endoscopy - methods</topic><topic>Gastrins</topic><topic>Gastritis, Atrophic - pathology</topic><topic>Gastritis, Atrophic - therapy</topic><topic>Gastroenterology. Liver. Pancreas. Abdomen</topic><topic>Humans</topic><topic>Medical sciences</topic><topic>Neuroendocrine Tumors - diagnosis</topic><topic>Neuroendocrine Tumors - pathology</topic><topic>Neuroendocrine Tumors - therapy</topic><topic>Polyps - pathology</topic><topic>Prognosis</topic><topic>Stomach Neoplasms - diagnosis</topic><topic>Stomach Neoplasms - pathology</topic><topic>Stomach Neoplasms - therapy</topic><topic>Stomach. Duodenum. Small intestine. Colon. Rectum. Anus</topic><topic>Tumors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Basuroy, R.</creatorcontrib><creatorcontrib>Srirajaskanthan, R.</creatorcontrib><creatorcontrib>Prachalias, A.</creatorcontrib><creatorcontrib>Quaglia, A.</creatorcontrib><creatorcontrib>Ramage, J. K.</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Alimentary pharmacology & therapeutics</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Basuroy, R.</au><au>Srirajaskanthan, R.</au><au>Prachalias, A.</au><au>Quaglia, A.</au><au>Ramage, J. K.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Review article: the investigation and management of gastric neuroendocrine tumours</atitle><jtitle>Alimentary pharmacology & therapeutics</jtitle><addtitle>Aliment Pharmacol Ther</addtitle><date>2014-05</date><risdate>2014</risdate><volume>39</volume><issue>10</issue><spage>1071</spage><epage>1084</epage><pages>1071-1084</pages><issn>0269-2813</issn><eissn>1365-2036</eissn><notes>ObjectType-Article-2</notes><notes>SourceType-Scholarly Journals-1</notes><notes>ObjectType-Feature-3</notes><notes>content type line 23</notes><notes>ObjectType-Review-1</notes><abstract>Summary
Background
Gastric carcinoids (GCs) or neuroendocrine tumours (NETs) are increasingly identified at endoscopy, and account for 0.6–2% of all gastric polyps identified. The SEER database in the US has demonstrated a rising incidence of gastric NETs amongst all NETs; from 2.2% between 1950 and 1969 to 6.0% between 2000 and 2007.
Aim
To review the literature and assist clinicians in managing patients with GCs.
Methods
A literature search was conducted through MEDLINE using search terms: gastric, carcinoid, neuroendocrine tumour, therapy, endoscopy, mucosal resection, submucosal dissection. Relevant articles were identified through manual review. The reference lists of these articles were reviewed to include further appropriate articles.
Results
There are three types of GCs with important epidemiological, pathophysiological, histological and endoscopic differences that affect prognosis and management. Type 1 and 2 GCs develop in the context of hypergastrinaemia that originates from achlorhydria in atrophic gastritis and a gastrinoma, respectively. Type 3 GCs occur sporadically and independent of gastrin. The histological type, grade and Ki67 index are used to determine prognosis and direct clinical management. Type 1 GCs >1 cm in size and type 2 GCs should be assessed for invasion beyond the submucosa with EUS prior to endoscopic resection with EMR or ESD. Type 3 GCs should be managed as per recommendations for gastric adenocarcinoma. The treatment of advanced disease is multimodal.
Conclusions
Patients with gastric carcinoids should be discussed in a specialist neuroendocrine tumour multidisciplinary meeting to ensure all treatment options are explored in localised and advanced disease. Areas of controversy exist that need further research.</abstract><cop>Oxford</cop><pub>Blackwell</pub><pmid>24628514</pmid><doi>10.1111/apt.12698</doi><tpages>14</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0269-2813 |
| ispartof | Alimentary pharmacology & therapeutics, 2014-05, Vol.39 (10), p.1071-1084 |
| issn | 0269-2813 1365-2036 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_1517399113 |
| source | Wiley-Blackwell Journals |
| subjects | Biological and medical sciences Dissection - methods Endoscopy - methods Gastrins Gastritis, Atrophic - pathology Gastritis, Atrophic - therapy Gastroenterology. Liver. Pancreas. Abdomen Humans Medical sciences Neuroendocrine Tumors - diagnosis Neuroendocrine Tumors - pathology Neuroendocrine Tumors - therapy Polyps - pathology Prognosis Stomach Neoplasms - diagnosis Stomach Neoplasms - pathology Stomach Neoplasms - therapy Stomach. Duodenum. Small intestine. Colon. Rectum. Anus Tumors |
| title | Review article: the investigation and management of gastric neuroendocrine tumours |
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