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PubMed This is a summary of 14 peer-reviewed journal articles Updated
Oncology · Gastric Neuroendocrine Tumor

Your Path Forward: Understanding a Gastric NET Diagnosis

At a Glance

Most gastric neuroendocrine tumors (G-NETs) are slow-growing and behave very differently from standard stomach cancer. Treatment depends heavily on whether the tumor is Type 1, 2, or 3, with many patients only needing regular endoscopic monitoring rather than major surgery.

Receiving a diagnosis of a gastric neuroendocrine tumor (G-NET) can be overwhelming, especially since the word “tumor” or “cancer” often brings to mind aggressive diseases like standard stomach cancer. However, G-NETs are biologically very different from common stomach cancer (adenocarcinoma) [1][2]. While standard stomach cancer starts in the gland cells and often spreads quickly, most G-NETs come from hormone-producing cells and tend to grow very slowly [2][3].

Three Stabilizing Facts

If you have just been diagnosed, these three clinical realities can help you orient yourself:

  1. They are often “indolent”: This is a medical term for slow-growing. The most common form of G-NET (Type 1) frequently behaves more like a chronic condition that needs monitoring rather than an emergency that requires immediate, aggressive surgery [4][5].
  2. Excellent long-term outlook: For the majority of patients (especially those with Type 1), the prognosis is excellent [6]. Many people live with these for decades, with the tumors managed entirely through regular check-ups [7][4].
  3. Organ-preserving options: Unlike many other stomach cancers, G-NETs often do not require the removal of the stomach. Many can be managed through endoscopic resection (removing the tumor during a scope) or even simple observation for very small lesions [8][5].

Understanding the Three Types

G-NETs are not a single disease; they are classified into three main types based on what causes them to grow. Knowing your type is the most important step in understanding your path forward.

Feature Type 1 (Most Common) Type 2 (Rare) Type 3 (Rarest)
Frequency 70%–80% of cases [2] 5%–10% of cases [9] 10%–15% of cases [2]
Cause Low stomach acid (often from autoimmune issues) [1] High gastrin (often associated with MEN-1 syndrome) [9] Sporadic (no clear underlying cause) [2]
Behavior Usually small, multiple, and very slow-growing [1] Usually small and slow-growing [9] Usually a single, larger, and more aggressive tumor [2]
Treatment Surveillance or endoscopic removal [7] Manage the underlying hormone issue [10] Surgery (oncologic resection) [2]

Clearing Up Common Misunderstandings

Because G-NETs are rare, patients often encounter outdated or incorrect information.

  • “It’s the same as stomach cancer”: It is not. Standard stomach cancer (adenocarcinoma) and G-NETs come from different cell types and require different treatments [1][2].
  • “I need my stomach removed immediately”: This is rarely the case for Type 1 and Type 2 G-NETs. Current guidelines often recommend endoscopic surveillance (monitoring with a scope) for small tumors under 1 centimeter [11][5].
  • “Metastasis is inevitable”: For small Type 1 G-NETs, the risk of the tumor spreading to other organs (metastasis) is extremely low [4][8].

Why a Specialist Matters

G-NETs are rare, though they are being diagnosed more often now due to better screening [12][13]. Because the treatment for a Type 1 G-NET is vastly different from a Type 3, it is vital to work with a multidisciplinary team—including a gastroenterologist, an oncologist, and sometimes an endocrinologist—who specializes in neuroendocrine neoplasms [6][14]. A specialist will ensure you aren’t over-treated for a slow-growing tumor or under-treated for a more aggressive one.

Common questions in this guide

Is a gastric neuroendocrine tumor the same as stomach cancer?
No. A gastric NET is biologically very different from standard stomach cancer, which is known as adenocarcinoma. Most G-NETs grow very slowly from hormone-producing cells, whereas standard stomach cancer often spreads much faster and requires different treatment.
Will I need to have my stomach removed to treat a gastric NET?
Not usually. For the most common types of gastric NETs, current guidelines often recommend simple observation or removing the tumor during an endoscopy. Major surgery to remove part or all of the stomach is typically only required for the rarer, more aggressive Type 3 tumors.
Why does my doctor need to know the 'Type' of my gastric NET?
Gastric NETs are classified into three types based on their underlying cause and behavior. Type 1 is the most common and slow-growing, often requiring only regular monitoring. Type 2 is also slow-growing but tied to a rare genetic syndrome, while Type 3 is the rarest and may require prompt surgical removal.
What does the Ki-67 index mean on my pathology report?
The Ki-67 index is a test run on your biopsy sample that measures how fast the tumor cells are dividing. Your oncologist uses this percentage to understand how aggressive the tumor is, which directly helps them choose the safest and most effective treatment plan.

Questions to Ask Your Doctor

Curated prompts to bring to your next appointment.

  1. 1.Based on my biopsy, what is the specific 'Type' (Type 1, 2, or 3) and 'Grade' (G1, G2, or G3) of my tumor?
  2. 2.What was my Ki-67 index, and how does that number influence my treatment path?
  3. 3.Do I have evidence of chronic atrophic gastritis or pernicious anemia, and how does that change how we manage these tumors?
  4. 4.How many neuroendocrine tumor patients do you or this clinic treat annually?
  5. 5.Given the size and type of my tumor, am I a candidate for endoscopic surveillance or resection instead of major surgery?

Questions For You

Tap a prompt to share your answer — we'll use it plus this page's context to start a tailored conversation.

References

References (14)
  1. 1

    The changing face of chronic autoimmune atrophic gastritis: an updated comprehensive perspective.

    Massironi S, Zilli A, Elvevi A, Invernizzi P

    Autoimmunity reviews 2019; (18(3)):215-222 doi:10.1016/j.autrev.2018.08.011.

    PMID: 30639639
  2. 2

    Neuroendocrine Tumors of the Stomach.

    Corey B, Chen H

    The Surgical clinics of North America 2017; (97(2)):333-343 doi:10.1016/j.suc.2016.11.008.

    PMID: 28325190
  3. 3

    Gastric neuroendocrine tumors: 20-Year experience in a reference center.

    Ravizza D, Giunta M, Sala I, et al.

    Journal of neuroendocrinology 2024; (36(12)):e13440 doi:10.1111/jne.13440.

    PMID: 39191460
  4. 4

    Last decade of advances in gastric neuroendocrine tumors: Innovations, challenges, and future directions.

    Christodoulidis G, Kouliou MN, Ragias D, et al.

    World journal of clinical oncology 2025; (16(5)):104577 doi:10.5306/wjco.v16.i5.104577.

    PMID: 40503415
  5. 5

    The indolent nature of type 1 gastric neuroendocrine tumors under 1 cm.

    Dell'Unto E, Mandair D, Riding G, et al.

    Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver 2026; (58(1)):119-124 doi:10.1016/j.dld.2025.09.011.

    PMID: 41016874
  6. 6

    Management of Gastric Neuroendocrine Tumors: A Review.

    Sok C, Ajay PS, Tsagkalidis V, et al.

    Annals of surgical oncology 2024; (31(3)):1509-1518 doi:10.1245/s10434-023-14712-9.

    PMID: 38062290
  7. 7

    Management of type 1 gastric neuroendocrine tumors: an 11-year retrospective single-center study.

    Chen YY, Guo WJ, Shi YF, et al.

    BMC gastroenterology 2023; (23(1)):440 doi:10.1186/s12876-023-03079-6.

    PMID: 38097952
  8. 8

    Clinical Outcomes of Endoscopic Treatment for Type 1 Gastric Neuroendocrine Tumor.

    Noh JH, Kim DH, Yoon H, et al.

    Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract 2021; (25(10)):2495-2502 doi:10.1007/s11605-021-04997-0.

    PMID: 33825119
  9. 9

    A 15-year experience with gastric neuroendocrine tumors: Does type make a difference?

    Postlewait LM, Baptiste GG, Ethun CG, et al.

    Journal of surgical oncology 2016; (114(5)):576-580 doi:10.1002/jso.24369.

    PMID: 27393718
  10. 10

    GASTRIC NEUROENDOCRINE TUMOR: REVIEW AND UPDATE.

    Dias AR, Azevedo BC, Alban LBV, et al.

    Arquivos brasileiros de cirurgia digestiva : ABCD = Brazilian archives of digestive surgery 2017; (30(2)):150-154 doi:10.1590/0102-6720201700020016.

    PMID: 29257854
  11. 11

    Endoscopic surveillance alone is feasible and safe in type I gastric neuroendocrine neoplasms less than 10 mm in diameter.

    Exarchou K, Hu H, Stephens NA, et al.

    Endocrine 2022; (78(1)):186-196 doi:10.1007/s12020-022-03143-3.

    PMID: 35895180
  12. 12

    Gastric neuroendocrine tumor: A practical literature review.

    Roberto GA, Rodrigues CMB, Peixoto RD, Younes RN

    World journal of gastrointestinal oncology 2020; (12(8)):850-856 doi:10.4251/wjgo.v12.i8.850.

    PMID: 32879663
  13. 13

    Management of gastric and duodenal neuroendocrine tumors.

    Sato Y, Hashimoto S, Mizuno K, et al.

    World journal of gastroenterology 2016; (22(30)):6817-28 doi:10.3748/wjg.v22.i30.6817.

    PMID: 27570419
  14. 14

    Gastric carcinoids: Does type of surgery or tumor affect survival?

    Crown A, Kennecke H, Kozarek R, et al.

    American journal of surgery 2019; (217(5)):937-942 doi:10.1016/j.amjsurg.2018.12.057.

    PMID: 30686481

This page provides educational information about gastric neuroendocrine tumors (G-NETs). It is not intended as medical advice; always consult your oncology and gastroenterology team regarding your specific tumor type and treatment plan.

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