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EFFICACY OF ANTRECTOMY FOR PATIENTS WITH MULTIPLE TYPE I GASTRIC NEUROENDOCRINE TUMORS

Yuki Morita 1, Ken Namikawa 1, Yohei Ikenoyama 1, Yoshitaka Tokai 1, Shoichi Yoshimizu 1, Yusuke Horiuchi 1, Akiyoshi Ishiyama 1, Toshiyuki Yoshio 1, Toshiaki Hirasawa 1, Kaoru Nakano 1,2, Souya Nunobe 1, Junko Fujisaki 1

Affiliations

1 Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan

2 Cancer Institute, Japanese Foundation for Cancer Research, Tokyo, Japan

Summary

AI Generated

Antrectomy in seven patients with multiple type I gastric neuroendocrine tumors led to normalization of gastrin levels and tumor disappearance in six patients without recurrence over a median 48-month follow-up.

Seven patients with multiple type I gastric neuroendocrine tumors underwent antrectomy, either as initial treatment (three patients) or after endoscopic submucosal dissection (four patients).
Median gastrin levels decreased significantly from 3900 pg/mL preoperatively to 73 pg/mL after antrectomy.
Residual tumors disappeared in six patients and regressed in one patient, with a median time to disappearance of 20 months.
No recurrence or cause-specific death occurred during a median follow-up of 48 months.
The authors conclude that antrectomy may control local disease, prevent recurrence, and allow avoidance of total gastrectomy in patients with multiple type I gastric neuroendocrine tumors.

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This summary was generated by an AI large language model based on the content transcript. It is for informational purposes only and should not be considered a substitute for clinical judgment. Always rely on your professional expertise and the full clinical context when making clinical decisions.

Abstract

Introduction

Type I gastric neuroendocrine tumors (T1-GNETs) are caused by auto-immune gastritis and often occur in multiple lesions. Although endoscopic resection, such as endoscopic submucosal dissection (ESD), is often used for treatment of a small number of T1-GNET, antrectomy is also performed for multiple lesions. However, to date, the efficacy of antrectomy remains unclear.

Aims & Methods

Type I gastric neuroendocrine tumors (T1-GNETs) are caused by auto-immune gastritis and often occur in multiple lesions. Although endoscopic resection, such as endoscopic submucosal dissection (ESD), is often used for treatment of a small number of T1-GNET, antrectomy is also performed for multiple lesions. However, to date, the efficacy of antrectomy remains unclear.

Results

The median age of all patients was 54 years (range, 44–67 years). The ratio of male to female patients was 2:5. The number of tumors preoperatively observed in endoscopy was <10 in two patients, 10–20 in one, and >20 in four. The median size of largest tumor was 6 mm (range, 4–8 mm). Antrectomy was performed in three patients as initial treatment and in four as additional treatment after ESD. The number of tumors pathologically evaluated in resected specimens was <10 in four patients, 10–20 in two, and >20 in one. All tumors were limited to the submucosa. The median diameter of the largest tumor was 5 mm (range, 1.5–8 mm). The median gastrin levels significantly decreased from 3900 pg/mL (range, 2400–8000 pg/mL) to 73 pg/mL (range, 26–120 pg/mL) after antrectomy. Regarding postoperative assessment, tumor regression was observed in one patient and disappearance was observed in six at the follow-up endoscopy. The median period between antrectomy and tumor disappearance was 20 months (range, 5–49 months). No recurrence or cause-specific death occurred in all patients, with a median follow-up period of 48 months (range, 24–60 months).

	N=7
Age, median (range), years	54 (44-67)
Number of tumor (preoperative), n (%) < 10 10-20 > 20	2 (28.6) 1 (14.3) 4 (57.1)
Size of largest tumor (preoperative), median (range), mm	6 (4-8)
Number of tumor (resected specimen), n (%) < 10 10-20 > 20	4 (57.1) 2 (28.6) 1 (14.3)
Size of largest tumor (resected specimen), median (range), mm	5 (1.5-8)
Serum gastrin levels, median (range), pg/ml Pre Antrectomy Post Antrectomy	3900 (2400-8000) 73 (26-120)
Post Antrectomy status of residual tumors, n (%) Stable Progression Regression Disappearance	0 (0.0) 0 (0.0) 1 (14.3) 6 (85.7)
Period between Antrectomy and tumor disappearance, median (range), months After Antrectomy	20 (5-49)
Follow-up period after Antrectomy, median (range), month	Follow-up period after Antrectomy, median (range), month

Conclusion

Based on our findings, antrectomy does not only control local disease but also may lead to prevention of recurrence and regression of tumor persistence. Antrectomy was an effective treatment that could avoid total gastrectomy in patients with multiple T1-GNETs.

References

NCCN Clinical Practice Guidelines in Oncology: Neuroendocrine Tumors Version 2.2016

Conference

UEG Week Copenhagen 2023

Topics

Oesophagus

Submission format

Abstract

Session

PP 01 Oesophageal, gastric and duodenal disorders (Posters)

Citation

United European Gastroenterology Journal 2023; 11 (Supplement 8)

Published

2023

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