Carcinoids: The association of histologic growth pattern and survival

Abstract

There are five generally accepted carcinoid histologic growth patterns, i.e., insular, trabecular, glandular, undifferentiated, and mixed. To determine their possible prognostic significance, a panel of pathologists studied the growth patterns of 138 carcinoids collected from an Eastern Cooperative Oncology Group carcinoid advanced stage disease chemotherapy investigation. Survival times were measured from date of initial pathologic diagnosis of carcinoid disease to date of either death or last follow‐up. Significant differences were observed in survival times between the five major growth patterns (P < 0.001). Within the mixed growth pattern group, significant differences in survival time were also observed (P ≤ 0.05). In decreasing order of median survival time in years, the growth patterns ranked as follows: mixed insular plus glandular, 4.4; insular, 2.9; trabecular, 2.5; mixed insular plus trabecular, 2.3; three pooled low incidence rate mixed growth patterns, 1.4; glandular, 0.9; and undifferentiated, 0.5. Histologic growth patterns are recommended as a stratification factor in future studies of this disease.

Endoscopic Resection of Small Rectal Carcinoid Tumours Using an Aspiration Method with a Transparent Overcap

“…The median survival times were reported as 2.9 years for insular type, 2.5 years for trabecular type, 0.9 years for glandular type, and 0.5 years for undifferentiated type. 3 We conclude that rectal carcinoid tumours < 1 cm are successfully treated by endoscopic resection, and ultrasonographic examination (for depth of invasion) provides a valuable source of information before the resection is performed. et al…”

Treatment of poorly differentiated neuroendocrine tumours with etoposide and cisplatin

“…With chemotherapy, median overall survival was of 15-19 months compared to 6-7 months without treatment in the literature (Johnson et al, 1983;Staren et al, 1988;Rindi et al, 1996).…”

“…Up to now, treatment of GEP NET has been challenging, especially when the tumours are metastatic, since data concerning the prognosis factors are still scarce. Age, tumour size, stage and primary site may be related to the outcome of NET (Johnson et al, 1983;McDermott et al, 1994;Greenberg et al, 1987;Modlin and Sandor, 1997). According to Warren and Gould's classification (Gould et al, 1983;Warren et al, 1989), well-differentiated, moderately differentiated and poorly differentiated NET should also be distinguished since this classification has a therapeutic and prognostic impact.…”

“…In contrast to well-differentiated NET, the aggressiveness of poorly differentiated NET is similar to small-cell lung cancer (SCLC), resulting in a median survival of 6 months without treatment (Johnson et al, 1983;Staren et al, 1988;Rindi et al, 1996). Most patients have metastatic disease and poor condition at the time of diagnosis and cannot be approached surgically with curative intent (Hainsworth et al, 1988;Pelley and Bukowski, 1997).…”

Tumormikroenvironment in Neuroendokrinen Tumoren (NET) des gastroentero-pankreatischen Systems

“…Kolorektale Adenokarzinome sind in der Lage, neuroendokrine Marker wie Chromogranin, NSE und Leu-7 zu exprimieren; umgekehrt können kolorektale NET CEA exprimieren (Federspiel et al 1990 undifferenziertes Wachstumsmuster zeigen (Johnson et al 1983). Die schnell proliferierenden Tumorzellen verdrängen die Bindegewebsstränge und zerstören die Architektur des Stromas.…”