What are the NANETS guidelines on the treatment of gastric neuroendocrine tumors (NETs)?

Updated: Dec 23, 2018
  • Author: Evan S Ong, MD, MS; more...
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Answer

Answer

Gastric carcinoids can be subclassified into the following three distinct groups [13] :

  • Type I – Those associated with chronic atrophic gastritis/pernicious anemia (70-80%)

  • Type II – Those associated with Zollinger-Ellison syndrome with multiple endocrine neoplasia type I (MEN I) (5%)

  • Type III – Sporadic NETs of the stomach (15-20%)

In 2013, NANETS released updated guidelines with the following recommendations for treatment of gastric carcinoid tumors [14] :

  • Type I or II, < 1 cm: Surveillance or endoscopic removal

  • Type I, 1 cm to < 2 cm: Surveillance with repeat endoscopy every 3 years or endoscopic resection

  • Type II, 1 cm to < 2 cm: Endoscopic resection

  • Type I, ≥2 cm (≤6 polyps), or type II ≥2 cm: Endoscopic resection, if possible, or open surgical resection

  • Type I, ≥2 cm (>6 polyps): Individualized treatment required; surveillance, endoscopic resection, or surgical resection

  • Type III: Partial gastrectomy and lymph node dissection


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