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Surgical Intervention in Gastric Carcinoid is Associated With Improved Survival in Local and Regional Disease

Callahan, Ann F., MD; White, Michael, MD; Ituarte, Philip, PhD; Gagandeep, Singh, MD; Woo, Yanghee, MD; Fong, Yuman, MD; Melstrom, Laleh, MSCI, MD

American Journal of Clinical Oncology: September 2018 - Volume 41 - Issue 9 - p 882–887
doi: 10.1097/COC.0000000000000392
Original Articles: Gastrointestinal

Introduction: Gastric carcinoid is a rare entity with complex management options. This study aims to determine if surgical intervention in patients with local, regional, and metastatic gastric carcinoid is associated with prolonged survival.

Materials and Methods: The California Cancer Registry merged with the California Office of Statewide Health Planning and Development was queried for patients with a diagnosis of gastric carcinoid (2000 to 2011). Clinicopathologic characteristics, management, and outcomes were evaluated.

Results: There were 1012 patients with a diagnosis of gastric carcinoid identified. The median age was 63 (range, 18 to 99) and the majority of patients were women (615, 60.7%). Most patients had localized disease (644, 64%), whereas 9.4% (95) had regional and 13.4% (133) had distant metastases at diagnosis. The majority of patients underwent gastric surgery (56.7%, n=574 vs. 43.2%, n=438). Prolonged survival was associated with gastric surgery in patients with both local (median survival not reached; P<0.0001) and regional disease (27 mo with surgery vs. 5 mo with no surgery; P=0.0007). In patients who underwent gastrectomy and resection of hepatic metastasis, the survival approached those patients who had surgery for only regional disease (26 vs. 27 mo, P=0.8721).

Conclusions: Although the biology of the disease is the most significant predictor of overall outcome, when technically feasible and where comorbidities allow, aggressive endoscopic or surgical intervention should be offered for local and locoregional diseases, respectively.

Department of Surgery, City of Hope National Medical Center, Duarte, CA

Supported by the National Cancer Institute of the National Institutes of Health under award number NIH 5K12CA001727-20.

The content is solely the responsibility of Dr Laleh Melstrom (K12 Scholar) and does not necessarily represent the official views of the National Institutes of Health.

The authors declare no conflicts of interest.

Reprints: Laleh Melstrom, MSCI, MD, City of Hope Medical Center, 1500 East Duarte Rd, Duarte, CA 91010. E-mail: lmelstrom@coh.org.

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