Prognosis and Survival in Patients With Gastrointestinal Tract Carcinoid Tumors

Abstract

ObjectiveTo determine the impact of clinical presentation variables on the management and survival of patients with gastrointestinal (GI) tract carcinoid tumors. A 20-year (1975-1995) retrospective analysis of 150 patients with GI tract carcinoid tumors at the Massachusetts General Hospital was conducted. Median follow-up was 66 months (range 1-378). Survival estimates for prognostic factors were calculated using Kaplan-Meier product limit estimators, with death from carcinoid as the outcome. Univariate analyses for each factor were obtained using a log-rank test, and multivariate survival analysis was performed. Methods

Prognostic factors influencing survival from metastatic (stage IV) gastroenteropancreatic well-differentiated endocrine carcinoma

“…Additionally, in previous multivariate analysis from tertiary referral centers, pathological differentiation and stage at diagnosis have been identified as the strongest prognostic features of GEP NET. Indeed, differentiation of GEP NET classified as poorly compared with well-differentiated (WD) carcinoma (Johnson et al 1986, Greenberg et al 1987, Madeira et al 1998, Travis et al 1998, Rindi et al 1999, Lim et al 2005, Panzuto et al 2005, Asamura et al 2006, Faggiano et al 2007, Lepage et al 2007, Pape et al 2008 and stage (Lo et al 1996, Pelosi et al 1996, Burke et al 1997, Madeira et al 1998, Kirshbom et al 1999, Rindi et al 1999, Shebani et al 1999, Onaitis et al 2000, Quaedvlieg et al 2001, Rigaud et al 2001, Solorzano et al 2001, Hochwald et al 2002, Plöckinger et al 2004, Panzuto et al 2005, Tomassetti et al 2006, Baudin 2007, Pape et al 2008 as long been recognized the strongest prognostic parameters before the primary location. More recently, lymph node metastases (Hellman et al 2002, Cardillo et al 2004, Lim et al 2005, Tomassetti et al 2005, Baudin 2007, García-Yuste et al 2007, Rea et al 2007, Pape et al 2008 and proliferative index have emerged as major determinant of ...…”

Circulating markers of prognosis and response to treatment in patients with midgut carcinoid tumours

“…4 The majority of studies to date have investigated carcinoid tumours as a collective group. [5][6][7][8][9][10] Pulmonary, gastric, and midgut tumours (that include appendiceal tumours in many studies) are heterogeneous, 11 making interpretation of the available results specifically for midgut tumours very difficult. One of the few papers studying the effect of biochemical markers on survival for midgut carcinoid tumours concluded that only chromogranin A and increasing age were independent markers of outcome.…”

Laparoscopic versus open resection for appendix carcinoid

“…Patients treated for appendix carcinoid have an increased risk of second cancer [2,8,15,20,21], which was the case in 18% of our patients. The increased risk of second cancer in patients with carcinoid may be related to a genetic predisposition to certain cancer, including neuroendocrine and nonneuroendocrine tumors [21].…”

“…Appendectomy is one of the most common abdominal operations [7,9]. Appendix carcinoids are relatively indolent neoplasms, rarely associated with carcinoid syndrome [16,20], that are usually discovered in association with acute appendicitis [3,8], as was the case in 64% of our patients. Diagnosis is usually done either during operation or mainly during pathological examination of the resected appendix [2,8], which is corroborated by our results.…”