Progression after endoscopic treatment for type I gastric neuroendocrine tumors: A single-center retrospective study

BACKGROUND Endoscopic treatment is the primary therapy for type I gastric neuroendocrine tumors (G-NETs), but it may not address the underlying pathogenesis, increasing the risk of progression. AIM To investigate the effectiveness of endoscopic treatment and identify progression risk factors. METHODS This retrospective study involved 128 patients with type I G-NETs treated between January 2009 and May 2024. The patients were categorized into non-progressive (n = 87) and progressive (n = 41) groups. Baseline characteristics, treatment details, and follow-up data were analyzed using univariate and multivariate Cox regression analyses to identify prognostic variables. RESULTS The baseline characteristics analysis showed no significant differences between the groups. The median follow-up time was 25.5 months (14.00-58.50 months). The univariate and multivariate analyses confirmed that endoscopic treatment combined with adjuvant somatostatin analogs (SSAs) was associated with a lower risk of progression (hazard ratio = 0.38, 95% confidence interval: 0.17-0.90, P = 0.027), whereas a neutrophil-to-lymphocyte ratio (NLR) of ≥ 2 indicated a higher risk (hazard ratio = 2.14, 95% confidence interval: 1.08-4.26, P = 0.030). Kaplan-Meier analysis confirmed NLR ≥ 2 and adjuvant SSA use as independent prognostic variables. CONCLUSION Combining endoscopic treatment with SSAs is effective for managing type I G-NETs. SSAs and NLR were identified as independent prognostic factors, highlighting their potential to reduce recurrence risk and improve outcomes.