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Gastric Carcinoids: Biologic Behavior and Prognosis After Differentiated Treatment in Relation to Type
Open accessAbstract
OBJECTIVE: To analyze tumor biology and the outcome of differentiated treatment in relation to tumor subtype in patients with gastric carcinoid. BACKGROUND: Gastric carcinoids may be subdivided into ECL cell carcinoids (type 1 associated with atrophic gastritis, type 2 associated with gastrinoma, type 3 without predisposing conditions) and miscellaneous types (type 4). The biologic behavior and prognosis vary considerably in relation to type. METHODS: A total of 65 patients from 24 hospitals (51 type 1, 1 type 2, 4 type 3, and 9 type 4) were included. Management recommendations were issued for newly diagnosed cases, that is, endoscopic or surgical treatment of type 1 and 2 carcinoids (including antrectomy to abolish hypergastrinemia) and radical resection for type 3 and 4 carcinoids. RESULTS: Infiltration beyond the submucosa occurred in 9 of 51 type 1, 4 of 4 type 3, and 7 of 9 type 4 carcinoids. Metastases occurred in 4 of 51 type 1 (3 regional lymph nodes, 1 liver), the single type 2 (regional lymph nodes), 3 of 4 type 3 (all liver), and 7 of 9 type 4 carcinoids (all liver). Of the patients with type 1 carcinoid, 3 had no specific treatment, 40 were treated with endoscopic or surgical excision (in 10 cases combined with antrectomy), 7 underwent total gastrectomy, and 1 underwent proximal gastric resection. Radical tumor removal was not possible in 2 of 4 patients with type 3 and 7 of 9 patients with type 4 carcinoid. Five- and 10-year crude survival rates were 96.1% and 73.9% for type 1 (not different from the general population), but only 33.3% and 22.2% for type 4 carcinoids. CONCLUSION: Subtyping of gastric carcinoids is helpful in the prediction of malignant potential and long-term survival and is a guide to management. Long-term survival did not differ from that of the general population regarding type 1 carcinoids but was poor regarding type 4 carcinoids.
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“Small NETs are typically asymptomatic and often diagnosed incidentally.”
From AGA Clinical Practice Update on the Diagnosis and Management of Atrophic Gastritis: Expert Review (2021) · cites this paper as [88]
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“These usually appear as small to tiny nodules <10 mm and are most often found at the gastric corpus or fundus; they are typically well-differentiated with an indolent course.85–88”
From AGA Clinical Practice Update on the Diagnosis and Management of Atrophic Gastritis: Expert Review (2021) · cites this paper as [88]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
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“These usually appear as small to tiny nodules <10 mm and are most often found at the gastric corpus or fundus; they are typically well-differentiated with an indolent course.85–88”
From AGA Clinical Practice Update on the Diagnosis and Management of Atrophic Gastritis: Expert Review (2021) · cites this paper as [88]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
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“These usually appear as small to tiny nodules <10 mm and are most often found at the gastric corpus or fundus; they are typically well-differentiated with an indolent course.85–88”
From AGA Clinical Practice Update on the Diagnosis and Management of Atrophic Gastritis: Expert Review (2021) · cites this paper as [88]
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“Small NETs are typically asymptomatic and often diagnosed incidentally.”
From AGA Clinical Practice Update on the Diagnosis and Management of Atrophic Gastritis: Expert Review (2021) · cites this paper as [88]
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Metadata
- Authors
- Borch, K., Ahrén, B., Ahlman, H., Falkmer, S., Granérus, G., & Grimelius, L.
- Affiliations
- Linköping University Hospital (SE)
- Norwegian University of Science and Technology (NO)
- Uppsala University Hospital (SE)
- Corresponding author
- Borch, Kurt
- Venue
- Annals of Surgery
- Published
- 2005-07
- Volume
- 242
- Issue
- 1
- Pages
- 64-73
- ISSN
- 0003-4932 (ISSN-L)
- PMC
- PMC1357706
- OpenAlex
- W2033006867
- Cited by
- 287
- References
- 57
- Citations by year
- 2026: 1 · 2025: 7 · 2024: 9 · 2023: 8 · 2022: 8 · 2021: 21 · 2020: 8 · 2019: 11 · 2018: 18 · 2017: 18 · 2016: 8 · 2015: 23 · 2014: 13 · 2013: 21 · 2012: 25
- FWCI
- 6.69
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Annals of Surgery (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Lund University Publications (Lund University) (submittedVersion)
- Topics
- Health Sciences › Medicine › Oncology › Neuroendocrine Tumor Research Advances
- Health Sciences › Medicine › Oncology › Gastric Cancer Management and Outcomes
- Health Sciences › Medicine › Gastroenterology › Gastrointestinal Tumor Research and Treatment
- Keywords
- gastric carcinoid, cancer subtyping, atrophic gastritis, gastrinoma, hypergastrinemia, antrectomy, total gastrectomy, tumor infiltration, metastasis, survival, prognosis
- MeSH terms
- Adult, Aged, Aged, 80 and over, Carcinoid Tumor, Female, Gastrectomy, Gastric Mucosa, Gastrins, Gastroscopy, Humans, Male, Middle Aged, Neoplasm Staging, Probability, Prognosis, Prospective Studies, Stomach Neoplasms, Cohort Studies, Survival Rate, Proportional Hazards Models, Treatment Outcome, Risk Assessment
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