Factors Predicting Type I Gastric Neuroendocrine Neoplasia Recurrence: A Single-Center Study

Type I gastric neuroendocrine neoplasms (gNENs) are associated with atrophic gastritis and have a high recurrence rate, which means frequent endoscopies are required. The objective of this study was to identify factors predicting the local recurrence of type I gNENs. The clinical course and the pathological and biochemical data of patients with type I gNENs treated at Bnai Zion Medical Center between 2006 and 2022 were analyzed retrospectively. Twenty-seven type I gNENs were evaluated. The follow-up period was 41 months (range: 11–288 months). Recurrence of the tumor occurred in 13/27 (48%) patients after 35 months (median (M), interquartile range (IQR): 21–67.5). Serum gastrin levels were significantly higher in patients with recurrent disease versus patients with non-recurrent disease (788 vs. 394 ng/L; p = 0.047), while the Ki-67 index was significantly lower in patients with recurrent disease versus patients with non-recurrent disease (1% vs. 3.5%; p = 0.035). Tumor size, mitotic count, and serum chromogranin A levels did not correlate with recurrence. The present study emphasizes the role of gastrin in the pathogenesis of gNEN recurrence and highlights the debate regarding the ability of the Ki-67 index to predict the clinical course of this disease.

[1]  N. Stephens,et al.  New Developments in Gastric Neuroendocrine Neoplasms , 2022, Current Oncology Reports.

[2]  E. Pilozzi,et al.  Management of type-I gastric neuroendocrine neoplasms: A 10-years prospective single centre study. , 2021, Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver.

[3]  H. Köseoğlu,et al.  Gastric neuroendocrine neoplasms: A review , 2021, World journal of clinical cases.

[4]  D. Metz,et al.  Gastric Neuroendocrine Tumors: Reappraisal of Type in Predicting Outcome , 2021, Annals of Surgical Oncology.

[5]  G. Lee,et al.  Clinical Outcomes of Endoscopic Treatment for Type 1 Gastric Neuroendocrine Tumor , 2021, Journal of Gastrointestinal Surgery.

[6]  C. Shi,et al.  Gastric neuroendocrine tumours from long‐term proton pump inhibitor users are indolent tumours with good prognosis , 2020, Histopathology.

[7]  P. Sarder,et al.  Improving the accuracy of gastrointestinal neuroendocrine tumor grading with deep learning , 2020, Scientific Reports.

[8]  D. Pritchard,et al.  Systematic review: management of localised low‐grade upper gastrointestinal neuroendocrine tumours , 2020, Alimentary pharmacology & therapeutics.

[9]  Qiyun Tang,et al.  Trends of incidence and prognosis of gastric neuroendocrine neoplasms: a study based on SEER and our multicenter research , 2020, Gastric Cancer.

[10]  A. Faggiano,et al.  Tumour type and size are prognostic factors in gastric neuroendocrine neoplasia: A multicentre retrospective study. , 2019, Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver.

[11]  G. Kaltsas,et al.  Recurrence and metastatic potential in Type 1 gastric neuroendocrine neoplasms , 2019, Clinical endocrinology.

[12]  G. Kaltsas,et al.  Gastric neuroendocrine neoplasms type 1: A systematic review and meta-analysis , 2019, World journal of gastroenterology.

[13]  E. Pilozzi,et al.  Multidisciplinary Management of Neuroendocrine Neoplasia: A Real-World Experience from a Referral Center , 2019, Journal of clinical medicine.

[14]  F. Campbell,et al.  Netazepide, a gastrin/cholecystokinin‐2 receptor antagonist, can eradicate gastric neuroendocrine tumours in patients with autoimmune chronic atrophic gastritis , 2017, British journal of clinical pharmacology.

[15]  P. Ruszniewski,et al.  ENETS Consensus Guidelines Update for Gastroduodenal Neuroendocrine Neoplasms , 2016, Neuroendocrinology.

[16]  C. Divino,et al.  Management and Disease Outcome of Type I Gastric Neuroendocrine Tumors: The Mount Sinai Experience , 2015, Digestive Diseases and Sciences.

[17]  W. Travis,et al.  Pulmonary neuroendocrine (carcinoid) tumors: European Neuroendocrine Tumor Society expert consensus and recommendations for best practice for typical and atypical pulmonary carcinoids. , 2015, Annals of oncology : official journal of the European Society for Medical Oncology.

[18]  G. Kaltsas,et al.  Current concepts in the diagnosis and management of type 1 gastric neuroendocrine neoplasms , 2014, Clinical endocrinology.

[19]  G. Kaltsas,et al.  Metastatic type 1 gastric carcinoid: a real threat or just a myth? , 2013, World journal of gastroenterology.

[20]  I. Modlin,et al.  Gastric carcinoids (neuroendocrine neoplasms). , 2013, Gastroenterology clinics of North America.

[21]  Mohid S. Khan,et al.  A comparison of Ki-67 and mitotic count as prognostic markers for metastatic pancreatic and midgut neuroendocrine neoplasms , 2013, British Journal of Cancer.

[22]  G. Kaltsas,et al.  Long-term follow-up of a large series of patients with type 1 gastric carcinoid tumors: data from a multicenter study. , 2013, European journal of endocrinology.

[23]  E. Pilozzi,et al.  Type I Gastric Carcinoids: A Prospective Study on Endoscopic Management and Recurrence Rate , 2011, Neuroendocrinology.

[24]  M. Coleman,et al.  Carcinoid Tumors of the Gastrointestinal Tract: Trends in Incidence in England Since 1971 , 2010, The American Journal of Gastroenterology.

[25]  B. Niederle,et al.  Gastroenteropancreatic neuroendocrine tumours: the current incidence and staging based on the WHO and European Neuroendocrine Tumour Society classification: an analysis based on prospectively collected parameters. , 2010, Endocrine-related cancer.

[26]  S. Willich,et al.  Prognostic factors of long-term outcome in gastroenteropancreatic neuroendocrine tumours. , 2008, Endocrine-related cancer.

[27]  B. Skogseid,et al.  Prognostic Factors and Survival in 324 Patients with Pancreatic Endocrine Tumor Treated at a Single Institution , 2008, Clinical Cancer Research.

[28]  S. Willich,et al.  Prognostic relevance of a novel TNM classification system for upper gastroenteropancreatic neuroendocrine tumors , 2008, Cancer.

[29]  Manal M. Hassan,et al.  One hundred years after "carcinoid": epidemiology of and prognostic factors for neuroendocrine tumors in 35,825 cases in the United States. , 2008, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[30]  E. Wilander,et al.  Clinical symptoms, hormone profiles, treatment, and prognosis in patients with gastric carcinoids , 1998, Gut.

[31]  D. Ravizza,et al.  Clinical management of patients with gastric neuroendocrine neoplasms associated with chronic atrophic gastritis: a retrospective, multicentre study , 2015, Endocrine.