[The prognosis of carcinoid tumors of the stomach]

Abstract

Follow-up examinations were carried out in 55 patients with small carcinoid tumours in the stomach (diameter 0.5-1.7 cm). For the most part, the tumours were located within the body and fundus of the stomach, with only 3 being found in the antrum. Thirty-five of the 55 patients (63.6%) had multiple gastric carcinoids, while in 46 patients (83.6%) concomitant chronic atrophic gastritis was also present. Eight patients were treated surgically, while 47 patients were merely kept under endoscopic/bioptic surveillance. In 34 out of 40 patients in whom the diagnosis had been established more than 6 months previously (longest observation period 13 years), follow-up findings were available (7 surgical patients, 27 non-operated patients). The patients submitted to surgery (average follow-up period 3.5 years) are alive and free of complaints between 1 and 9 years post-op; no metastases have occurred, but a recurrent tumour has developed in a single patient. Among the 27 non-operated patients (average follow-up period 3.6 years), 3 have died of diseases unrelated to the carcinoid tumours, in none of the other patients has there been any change in the findings. On the basis of these results it is concluded that, in carcinoid tumours of the stomach with a diameter of less than 1.0 cm, surgical treatment is not absolutely necessary, and that, in comparison with the risks represented by surgical mortality and post operative morbidity, regular endoscopic/bioptic follow-up can be considered to be adequate.