CHU Dijon, hepato-gastroenterology unit, University of Bourgogne Franche-Comté, INSERM, LNC UMR1231, F-21000, Dijon, France.
Département d'Oncologie Médicale, Hospices Civils de Lyon, Hôpital Edouard Herriot, 69437, Lyon, cedex 03, France.
Endocrine. 2017 Sep;57(3):504-511. doi: 10.1007/s12020-017-1355-9. Epub 2017 Jun 29.
Gastric neuro-endocrine tumours are rare. European guidelines for the management of neuro-endocrine tumours have been published in 2012. The aim of our survey was to study the management of gastric neuro-endocrine tumours registered in the national cohort. A prospective national cohort registers the Neuro-endocrine tumours in France since January 2003 (GTE network). We reviewed all the individual medical reports of gastric neuro-endocrine tumours in order to collect data on treatment.
One hundred and ninety seven gastric neuro-endocrine tumours diagnosed between 1964 and 2013 in 20 centres were registered. For 181 cases data were considered complete for our survey. Eighty four tumours were type 1 (46.4%); five types 2 (2.8%); 52 types 3 (28.7%) and 40 types 4 (22.1%). Types 1 and 2 were first endoscopically managed in 93 and 60% of cases, respectively, whereas surgery was first done in 45 and 42%, respectively, of types 3 and 4. Systemic treatment, chemotherapy and/or somatostatin analogue, was first administered exclusively for types 3 and 4. Near 3% of types 1 and 40% of types 2 received at a time somatostatin analogue treatment. Five-year survival rates were 98.3, 100, 63.2 and 31.8% for types 1, 2, 3 and 4, respectively.
The great majority of gastric neuro-endocrine tumours registered in this national cohort are treated in accordance with the current guidelines. The survival rates we reported must be interpreted with caution, because this cohort registered preferentially selected patients eligible for treatment. The registration of all the gastric neuro-endocrine tumours, in particular type 1 considered as benign and type 4 not eligible for specific anti-cancer treatment must be encouraged.
胃神经内分泌肿瘤较为罕见。2012 年，欧洲发布了神经内分泌肿瘤管理指南。我们的研究旨在调查登记在全国队列中的胃神经内分泌肿瘤的管理情况。自 2003 年 1 月起，法国的 GTE 网络开始对神经内分泌肿瘤进行全国前瞻性队列登记。我们回顾了所有胃神经内分泌肿瘤的个体病历报告，以收集治疗数据。
我们在 20 个中心登记了 197 例 1964 年至 2013 年间诊断的胃神经内分泌肿瘤。有 181 例病例的数据可用于我们的调查。84 例为 1 型（46.4%）；5 例为 2 型（2.8%）；52 例为 3 型（28.7%）；40 例为 4 型（22.1%）。1 型和 2 型分别有 93%和 60%的病例首先经内镜治疗，而 3 型和 4 型分别有 45%和 42%的病例首先进行手术。仅对 3 型和 4 型患者首先进行全身性治疗、化疗和/或生长抑素类似物治疗。近 3%的 1 型和 40%的 2 型患者同时接受生长抑素类似物治疗。1 型、2 型、3 型和 4 型的 5 年生存率分别为 98.3%、100%、63.2%和 31.8%。
在这个全国性队列中登记的胃神经内分泌肿瘤绝大多数都按照当前指南进行治疗。我们报告的生存率必须谨慎解释，因为该队列优先登记了适合治疗的患者。必须鼓励对所有胃神经内分泌肿瘤进行登记，特别是被认为良性的 1 型和不适合特定抗癌治疗的 4 型。
