Endocrine Abstracts

Background: The exact indications and/or the type of operation requiring for the treatment of gastric carcinoids (GC) type 1, are not clearly stated. The present study was designed to evaluate the value of the oncological gastrectomy in the treatment of GC type 1.

Materials and method: Between January 2004 and December 2010, we advocated gastric resection in cases of GC type 1 when at least one of the following criteria was present: i) multiple recurrent lesions, ii) lesions with positive margins following endoscopic resection, iii) lesions with malignant potential (deep gastric parietal wall invasion, lymph node enlargement, Ki67 proliferative index >2%) and/or iv) presence of metastatic disease. Preoperatively, all patients had undergone laboratory tests (serum gastrin and chromogranin A measurements) and imaging investigations for exclusion of the Zollinger–Ellison and the MEN1 syndromes. In addition, all patients underwent either computerized tomography (CT) and/or magnetic resonance imaging (MRI) of the abdomen, as well as scintigraphy with ¹¹¹In-pentetreotide (Octreoscan). endoscopic ultrasound (EUS) was performed in four patients. A modified subtotal D2 lymphadenectomy was routinely performed.

Results: Seven patients (five females) were surgically treated. Four patients fulfilled one and three patients fulfilled two criteria. Fifteen to thirty-six perigastric lymph nodes were histologically retrieved per patient, but metastatic infiltration was noticed only in a patient with hepatic metastases. Within a median follow-up of 34 months, all patients are alive without any evidence of recurrence.

Conclusion: Extended peri- and extra-gastric lymphadenectomy did not prove to be necessary for non-malignant localized GC type 1, either for staging or therapeutically.