Gastric neuroendocrine neoplasms

Area of Science:

• Gastroenterology
• Endocrinology
• Oncology

Background:

• Gastric neuroendocrine neoplasms (gNENs) exhibit unique site-specific characteristics.
• The incidence and prevalence of gNENs have notably increased in recent decades.
• gNENs encompass gastric neuroendocrine carcinomas (gNECs) and gastric neuroendocrine tumors (gNETs), with gNETs further categorized into three distinct types.

Purpose of the Study:

• To review the classification and distinct clinical features of gastric neuroendocrine neoplasms.
• To outline the varied multidisciplinary management approaches required for different gNEN subtypes.
• To emphasize the need for enhanced understanding of gNEN pathophysiology to improve patient outcomes.

Main Methods:

• Review of existing literature on gastric neuroendocrine neoplasms.
• Analysis of classification systems for gNETs and gNECs.
• Discussion of current treatment modalities based on tumor type and clinical presentation.

Main Results:

• Type I and II gNETs are gastrin-dependent, associated with chronic atrophic gastritis or Zollinger-Ellison syndrome/MEN1, respectively.
• Type III gNETs occur without hypergastrinemia in various gastric mucosal conditions.
• gNECs can arise in diverse gastric environments and often require systemic treatment due to metastatic potential.

Conclusions:

• Each gNEN subtype necessitates a tailored, multidisciplinary approach.
• Current systemic treatment data for gNENs are often extrapolated from intestinal NENs and NECs.
• Further research into the molecular and clinical pathophysiology of gNENs is crucial for advancing patient care.