Carcinoid tumour

Caplin, Martyn; Buscombe, J. R.; Hilson, A. J.W.; Jones, Alison L; Watkinson, Anthony; Burroughs, Andrew K.

doi:10.1016/s0140-6736(98)02286-7

Cited by 333 publications

(225 citation statements)

References 66 publications

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“…It is an established treatment option in acromegaly and in a variety of other clinical conditions such as TSH-secreting pituitary adenomas, pancreatic islet-cell tumors and carcinoid tumors [1][2][3][4]. In recent years a long-acting sustained-release formulation of octreotide (octreotide LAR) has been developed, which contains octreotide in a biodegradable polymer complex [5].…”

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confidence: 99%

Normal Delivery Following an Uneventful Pregnancy in a Japanese Acromegalic Patient after Discontinuation of Octreotide Long Acting Release Formulation at an Early Phase of Pregnancy

et al. 2006

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Abstract. We report a 35-year-old woman with active acromegaly despite pituitary surgery and irradiation who received continuous octreotide LAR treatment for the control of GH excess until discovery of her pregnancy. The patient delivered a healthy boy following an uneventful pregnancy after discontinuing octreotide LAR as soon as possible at the early phase of pregnancy. Despite a substantial maternal-fetal transfer of octreotide, postnatal development was normal at 3 years of age. In almost all previously described cases, octreotide was discontinued after pregnancy was confirmed. No side-effects of mother or fetus have been reported. Octreotide treatment in pregnancy seems to be feasible and safe. Due to the stilllimited number of reported cases treated with octreotide LAR, the potential benefits of octreotide LAR treatment should be weighed carefully against its possible risks.

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confidence: 99%

Normal Delivery Following an Uneventful Pregnancy in a Japanese Acromegalic Patient after Discontinuation of Octreotide Long Acting Release Formulation at an Early Phase of Pregnancy

et al. 2006

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“…3,4 However, octreotide appears to be the most efficacious treatment for carcinoid syndrome reducing symptoms in more than 70% of patients. 14,15 Serotonin antagonists were used in the past with limited success but may still have a role as a second line treatment if octreotide therapy fails. Other pharmacological interventions suppressed symptoms only occasionally, and often resulted in significant side effects.…”

Section: Discussionmentioning

confidence: 99%

“…Other pharmacological interventions suppressed symptoms only occasionally, and often resulted in significant side effects. 14,15 The octreotide dosing regimen chosen for perioperative management consisted of 50 µg and a 50 µg iv injection prior to incision, followed by a continuous iv infusion of 50 µg·hr -1 , and additional 50 µg boluses to treat episodes of hemodynamic instability. The outlined dosing regimen seems to be the best documented.…”

Section: Discussionmentioning

confidence: 99%

Orthotopic liver transplantation for carcinoid tumour metastatic to the liver: anesthetic management

Claure

Drover

Haddow

et al. 2000

Can J Anesth/J Can Anesth

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Purpose: To report the anesthetic management of a patient with carcinoid tumour metastatic to the liver who presented for orthotopic liver transplantation. Anesthetic implications of metastatic carcinoid tumour on liver transplantation and the use of octreotide are discussed.Clinical features: A 51-yr-old woman with intestinal carcinoid tumour metastatic to the liver presented for orthotopic liver transplantation, a recent treatment option for patients with extensive hepatic carcinoid metastases and disabling symptoms unresponsive to conventional therapy. Despite continuous administration of the somatostatin analogue octreotide via a hepatic artery infusate pump, the patient suffered from daily break through symptoms, which included flushing, palpitations, paroxysmal hypertension, and dyspnea. The patient presented to the operating room with sinus tachycardia and severe arterial hypertension. Octreotide and phentolamine were used to prevent further mediator release and to control the paroxysmal hypertension. Midazolam, fentanyl, thiopental, succinylcholine, vecuronium, and isoflurane were used to induce and maintain anesthesia safely. An intravenous octreotide infusion was initiated after induction and continued throughout the case. Infrequent and non-threatening peaks in arterial blood pressure were readily treated with small intravenous doses of vasoactive drugs and octreotide. No other manifestations of the carcinoid syndrome occurred. The patient had an uneventful recovery and was discharged on postoperative day #6. Conclusion:The patient safely underwent orthotopic liver transplantation for treatment of symptomatic carcinoid tumour metastatic to the liver. The anesthetic management followed recent recommendations favouring the use of octreotide to prevent patients from becoming symptomatic. Outlined dosing regimen for octreotide provided satisfactory hemodynamic stability.Objectif : Présenter le traitement anesthésique d'une patiente atteinte d'une tumeur carcinoïde, avec métastase au foie, admise pour une transplantation hépatique orthotopique. Les implications anesthésiques de la tumeur sur la transplantation du foie et l'usage d'octréotide sont étudiées. Éléments cliniques : Une femme de 51 ans souffrant d'une tumeur intestinale carcinoïde, avec métastase au foie, s'est présentée pour une transplantation du foie orthotopique, une nouvelle option thérapeutique pour les patients chez qui les métastases carcinoïdes du foie sont étendues et les symptômes invalidants ne sont pas éliminés par la thérapie traditionnelle. Malgré l'administration continue d'un analogue de la somatostatine, l'octréotide, au moyen d'une perfusion insérée dans l'artère hépatique, la patiente souffrait d'une poussée quotidienne de symptômes qui comprenaient des bouffées vasomotrices, des palpitations, de l'hypertension paroxystique et de la dyspnée. À son arrivée à la salle d'opération, la patiente présentait une tachycardie sinusale et une hypertension artérielle sévère. Conclusion : La patiente a subi en toute sécurité une transpla...

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“…Another possibility is treatment with radiolabelled MIBG, based on a positive scintigraphy which leads to long-term palliation in 60% of patients. Although reduction in tumour growth is rarely reported, stable disease is described in a substantial proportion of the patients (Taal et al 1996, Caplin et al 1998, Mukherjee et al 2001, Pathirana et al 2001. Worldwide experience with 131 I-MIBG diagnostic imaging has indicated a cumulative sensitivity of 70% in 237 patients with carcinoid tumours (Hoefnagel 1991).…”

Section: Introductionmentioning

confidence: 99%

Interferon and meta-iodobenzylguanidin combinations in the treatment of metastatic carcinoid tumours

Zuetenhorst

Olmos

Muller

et al. 2004

Endocr Relat Cancer

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Interferon (IFN) and meta-iodobenzylguanidin (MIBG) are active in metastatic carcinoids. In a phase II study, we evaluated the effect upon diagnostic 131 I-MIBG uptake and the clinical response of the combination. 131I-MIBG scintigraphy was performed prior to treatment, after 8 weeks of IFN and after unlabelled MIBG. The tumour over non-tumour (T/NT) ratios were quantitatively determined by comparing counts in the centre of the tumour (liver metastases) with those in an adjacent area of normal liver uptake (T/NT1) and with abdominal background area (T/NT2).The T/NT1 ratio showed an increase of > 10% in only four out of 21 patients (19%) after IFN ðP ¼ 0:178Þ and significantly more often in nine out of 18 patients (50%) after unlabelled MIBG ðP ¼ 0:016Þ. The absolute uptake in tumour deposits was also increased if compared with the abdominal background (T/NT2: 23% increase after IFN and 83% increase after unlabelled MIBG). The combination produced 91% of patients with stable disease (using World Health Organisation criteria) at computed tomography scan and a biochemical response (a reduction of at least 50% in urinary 5-hydroxyindolacetic acid excretion) in 39%.IFN-a did not significantly improve tumour retention of 131 I-MIBG. In contrast, unlabelled MIBG significantly improved biodistribution and tumour uptake in 83%. A synergistic effect was not seen.

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Carcinoid tumour

Cited by 333 publications

References 66 publications

Normal Delivery Following an Uneventful Pregnancy in a Japanese Acromegalic Patient after Discontinuation of Octreotide Long Acting Release Formulation at an Early Phase of Pregnancy

Normal Delivery Following an Uneventful Pregnancy in a Japanese Acromegalic Patient after Discontinuation of Octreotide Long Acting Release Formulation at an Early Phase of Pregnancy

Orthotopic liver transplantation for carcinoid tumour metastatic to the liver: anesthetic management

Interferon and meta-iodobenzylguanidin combinations in the treatment of metastatic carcinoid tumours

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