Intermittent treatment of recurrent type-1 gastric carcinoids with somatostatin analogues in patients with chronic autoimmune atrophic gastritis

Dig Liver Dis. 2015 Nov;47(11):978-83. doi: 10.1016/j.dld.2015.07.155. Epub 2015 Aug 8.

Abstract

Background: Optimal management and treatment of type-1 gastric carcinoids is under debate.

Aims: This prospective study evaluates the outcome of patients with recurrent type-1 gastric carcinoids treated with somatostatin analogues.

Methods: From 2000 to 2013, among a population of 107 chronic atrophic gastritis patients, 25 (20% males, median age 62 years) developed type-1 gastric carcinoids and underwent regular clinical and endoscopic follow-up (median 77 months, range 6-165) after the initial treatment. Those patients showing recurrent disease were treated with somatostatin analogues until carcinoid disappearance.

Results: 12/25 patients (33% males, median age 65 years) showed recurrent gastric carcinoids and were treated with somatostatin analogues for a median duration of 12 months. Median gastrin and chromogranin A levels, which were 802 pg/mL and 33 U/L, respectively, decreased to 299 pg/mL (p=0.002) and 15.6 U/L (p=0.001) at the end of the treatment. Gastric carcinoids disappeared after a median length of treatment of 12 months. After a median time of 19.5 months from somatostatin analogues discontinuation, 4/12 patients (25% males, median age 56 years) showed a further recurrence. A new cycle of treatment was performed successfully.

Conclusions: This study confirms that type-1 gastric carcinoids are a recurring disease and somatostatin analogues, administered on 12-month cycles, represent an effective treatment.

Keywords: Lanreotide; Neuroendocrine tumours; Octreotide.

Publication types

  • Clinical Study

MeSH terms

  • Aged
  • Aged, 80 and over
  • Antineoplastic Agents, Hormonal / therapeutic use*
  • Autoimmune Diseases / complications*
  • Carcinoid Tumor / complications
  • Carcinoid Tumor / drug therapy*
  • Chromogranin A / metabolism
  • Cohort Studies
  • Female
  • Gastrins / metabolism
  • Gastritis, Atrophic / complications*
  • Humans
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local / complications
  • Neoplasm Recurrence, Local / drug therapy*
  • Octreotide / therapeutic use*
  • Peptides, Cyclic / therapeutic use*
  • Prospective Studies
  • Somatostatin / analogs & derivatives*
  • Somatostatin / therapeutic use
  • Stomach Neoplasms / complications
  • Stomach Neoplasms / drug therapy*
  • Treatment Outcome

Substances

  • Antineoplastic Agents, Hormonal
  • Chromogranin A
  • Gastrins
  • Peptides, Cyclic
  • lanreotide
  • Somatostatin
  • Octreotide