Somatostatin Analogues as a Therapeutic Option in a Series of 91 Patients with Gastric Carcinoids Abstract #184

Introduction: Gastric carcinoid tumors (GC) represent about 10-30% of carcinoid tumors and about 1% of all stomach neoplasms. They include three types : type 1 (70-85%), type 2 (5-10%) and type 3 (15-25%).
Aim(s): To evaluate the diagnostic approach and the significance of somatostatin analogues (SSA's) as a therapeutic option for patients (pts) with GC.
Materials and methods: Twenty-three males and 58 females with GC (mean age at diagnosis 60.5 years) refered to our Section of GI Neuroendocrinology over the last 20 years. Follow-up period ranged from 24 to 108 months. They were evaluated for serum gastrin and CgA levels and with gastroscopy every six months, before, during and after the treatment with SSA's.
Conference: 8th Annual ENETS Conference (2011)
Category: Clinical
Presenting Author: MD Christos St. Basagiannis

To read results and conclusion, please login ...

Further abstracts you may be interested in

#18 Long-acting release octreotide induce complete response in type 1 gastric carcinoid tumors
Introduction: Gastric endocrine tumors (GET) are increasingly recognized due to expanding indications of upper gastrointestinal endoscopy. Often silent and benign, GET may also be aggressive when sporadic and may sometimes mimic the course of gastric adenocarcinoma. Current incidence of GETs is estimated at around 8% of digestive endocrine tumors. Yearly age-adjusted incidence is around 0.2 per population of 100,000. Gastric carcinoids (ECLomas) develop from gastric enterochromaffin-like cells (ECL cells) in response to chronically elevated gastrin. Type 1 tumors (ECLomas in the course of atrophic gastritis) may occur in conditions of achlorhydria secondary to auto-immune atrophic fundic gastritis. It occurs mostly in women and they are non-functioning tumors, typically found during upper GI endoscopy performed for dyspepsia. ECLomas present frequently as multiple polyps, usually < 1 cm in diameter in the gastric fundus. Type 1 tumors are almost exclusively benign lesions with little risk of deep invasion of the gastric parietal wall. The neoplastic ECL cells become progressively dedifferentiated with an increasing number of Ki-67 immunoreactive (IR) cell nuclei. In addition, there is a substantial decrease in argynophil and IR NE cells that can be visualized by conventional methods. ECLomas secondary to hypergastrinemia should be closely followed for signs of clinical and histopathological tumor progression. Such ECLomas deserve early, active, radical surgical treatment.
Traditionally, gastric carcinoid type 1 (GCA1s) are endoscopically or surgically removed, depending on the number, appearance and size of the tumors. Antrectomy, with surgical excision of the majority of the G cells, is thought to facilitate regression of these tumors by removing the source of excessive gastrin secretion; however, the long-term benefits of antrectomy still remain uncertain. Although proton pump inhibitors are effective in reducing hypergastrinemia-induced gastric acid hypersecretion in GCA2, they do not affect ECL-cell hyperplasia, and therefore their role in GCA1 is limited. Moreover, in selected cases, significant reduction of hypergastrinemia does not prevent development of ECL carcinoid, suggesting that, in addition to hypergastrinemia, other pathogenic or genetic factors may be involved. Treatment with somatostatin analogues (SSA) might impede ECL-cell hyperplasia by suppressing gastrin secretion and/or by a direct anti-proliferative effect on ECL cells. Treatment with SSAs in GCA1 leads to a substantial tumor load reduction, with a concomitant decrease of serum gastrin levels. Published data indicate an important anti-proliferative effect of SSA on ECL cells, providing clinical benefit and obviating, at least temporarily, the need for invasive therapies for GCA1. Morphometric studies demonstrated that, while antrectomy specifically decreased the volume of ECL cells versus the total volume of endocrine cells, octreotide reduces the overall endocrine cell volume. Although the number of treated patients is small, it has been suggested that SSA may exert important anti-proliferative effects either directly, by inhibiting ECL-cells proliferation, or indirectly through suppression of gastrin hypersecretion.
Conference: 7th Annual ENETS Conference (2010)
Category: Clinical
Presenting Author: MD Ricardo Caponero
#190 Complete Remission in a Patient with Metastatic Type 1 Gastric Carcinoid (GCA1) Treated with a Long-acting Somatostatin Analogue
Introduction: Surgery is the treatment of choice for invasive and metastatic GCA1. Somatostatin analogues have been successfully used in GCA1 patients without signs of malignancy.
Conference: 8th Annual ENETS Conference (2011)
Category: Clinical
Presenting Author: Dr merav Fraenkel
#267 Plasma Somatostatin: Gastrin Ratio Improves the Diagnosis of Gastrinoma
Introduction: Fasting gastrin alone is inadequate for diagnosis of gastrinoma. Diagnosis requires confirmation of low gastric pH. Low gastric pH is associated with increased numbers of D (somatostatin) cells.
Conference: 8th Annual ENETS Conference (2011)
Category: Basic
Presenting Author: Dr Radha Ramachandran
#392 A 67-Year Old Woman with a Carcinoid Tumor of the Coccyx with Liver Metastases
Introduction: Neuroendocrine tumors (NETs) are tumors of the interface between the endocrine and nervous system. They are characterized by the presence of secretory granules, as well as the ability to produce biogenic amines and polypeptide hormones. The clinical behavior of NETs is extremely variable; they may be functioning or non-functioning, ranging from very slow-growing tumors, which are the majority, to highly aggressive and very malignant tumors. Many case reports of rare sites of primary NETs outside the gastrointestinal tract have been described, as tumors with neuroendocrine characteristics can occur in virtually any organ or tissue. Nevertheless, this is the first case of a metastatic coccygeal carcinoid tumor ever described.
Conference: 9th Annual ENETS Conference (2012)
Category: Basic
Presenting Author: Dr Theodors Angelopoulos
#406 YF476, a Gastrin Receptor Antagonist, Causes Regression of Tumors and Normalizes Serum Chromogranin A in Patients with Type 1 Gastric Carcinoids
Introduction: Chronic atrophic gastritis (CAG) results in achlorhydria, hypergastrinemia and, in some patients, gastric carcinoids (type 1 GCs). Type 1 GCs may become malignant and metastasize. Current treatments of type 1 GCs, such as polypectomy, somatostatin analogues and antrectomy, have their disadvantages. YF476 – a potent, selective, orally active and well-tolerated gastrin receptor antagonist in pre-clinical studies – prevented, as well as reduced, the number and size of gastric carcinoids and carcinomas in rodent models.
Conference: 9th Annual ENETS Conference (2012)
Category: Clinical
Presenting Author: Reidar Fossmark
Close
Notice

WARNING – FRAUDULENT WEBSITES

ENETS is aware that its members have been confronted with fake websites, which seem to relate to our congress but have not been commissioned or authorised by us. The websites offer fraudulent hotel reservation services. We therefore strongly recommend that you please only use the official enetsconference.org website when booking your tickets and accommodation. Please be vigilant when it comes to providing your credit card details. 

If you have any questions, please do not hesitate to contact us at info@enets.org.