Clinical science
Typical carcinoids and neuroendocrine carcinomas of the stomach: differing clinical courses and prognoses

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Abstract

Background

Gastric endocrine tumors are usually classified as 3 types of well-differentiated endocrine tumors (typical carcinoids or carcinoids) and poorly differentiated carcinomas (neuroendocrine carcinomas [NECs]).

Methods

From 1993 to 2008, 97 patients (73 men and 24 women) were diagnosed with gastric neuroendocrine tumors at the Asan Medical Center.

Results

Of the 45 patients with typical carcinoids, 37 underwent surgery (eg, endoscopic resection). Of the 52 patients with NECs, 43 underwent surgery (eg, radical gastrectomy). One patient died of recurrence of the typical carcinoids, whereas 26 patients with NECs died of related diseases (P < .05). The rates of survival and recurrence did not significantly differ by type of typical carcinoid (P > .05).

Conclusions

Regardless of the type, carcinoids that are not yet advanced can be effectively treated with minimal endoscopic or laparoscopic surgery. However, all NECs and advanced carcinoids should be treated with radical gastrectomy.

Section snippets

Patients and Methods

Between February 1993 and March 2008, 97 patients were diagnosed with gastric carcinoids or neuroendocrine carcinomas at the Asan Medical Center in Seoul, Korea. The authors obtained 79 tissues from surgical specimens and 18 tissues from endoscopic biopsies. The histologic pattern was determined from hematoxylin and eosin–stained sections. Immunohistochemical studies were performed using chromogranins; synaptophysin; and, in some cases, neuron-specific enolase.

Tumors were classified as either

Results

The median age of all patients at the time of diagnosis was 59 years, ranging from 25 years to 80 years. The average follow-up period was 68 ± 45 months. There were 73 men and 24 women with a male-to-female ratio of 3:1. The authors found no significant difference in the age distribution of men and women (P = .187). Forty-five patients were diagnosed with carcinoids, and 52 were diagnosed with NECs. Of the 45 patients with carcinoids, 22 were diagnosed with type 1, 1 with type 2, 16 with type

Comments

It is easy to diagnose endocrine tumors of the stomach via endoscopic biopsy and distinguish typical benign carcinoids from NECs by hematoxylin and eosin staining and immunohistochemical studies.10, 24 Although carcinoids are classified by additional data (eg, atrophic gastritis, gastrin, and anemia), it is not always possible to classify each type.12 In our study, 39 (86.7%) of the 45 patients with typical carcinoids were classified as 1 of the 3 types; however, 6 cases could not be classified.

References (24)

  • G. Rindi et al.

    Gastric carcinoids and neuroendocrine carcinomas: pathogenesis, pathology, and behavior

    World J Surg

    (1996)
  • R.M. Thomas et al.

    Gastric carcinoidsAn immunohistochemical and clinicopathologic study of 104 patients

    Cancer

    (1994)

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