The Management of Patients with Advanced Carcinoid Tumors and Islet Cell Carcinomas

Moertel, Charles G.; Johnson, Carla; McKusick, Michael A.; Martin, J. Kirk; Nagorney, David M.; Kvols, Larry K.; Rubin, Joseph; Kunselman, Susan J.

doi:10.7326/0003-4819-120-4-199402150-00008

Cited by 276 publications

(129 citation statements)

References 0 publications

Supporting

Mentioning

121

Contrasting

Unclassified

Order By: Relevance

“…At tumour progression, additional treatment with cytotoxic drugs was given (streptozotocin and 5-fluorouracil alternated with doxorubicin; cf. Moertel et al, 1994).…”

Section: Patients and Treatmentmentioning

confidence: 99%

“…At tumour progression, additional treatment with cytotoxic drugs was given (streptozotocin and 5-fluorouracil alternated with doxorubicin; cf. Moertel et al, 1994).During the same period, 25 consecutive patients with sporadic malignant EPT (mean age 50 years, range 17-77) were treated at our unit. All patients were surgically explored and underwent radical surgery or surgical debulking, if more than 90% of the intrahepatic metastases could be removed safely (cf.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Comparison of survival between malignant neuroendocrine tumours of midgut and pancreatic origin

et al. 1999

View full text Add to dashboard Cite

Neuroendocrine tumours of the gastrointestinal tract are rare diseases and with the presence of metastases, patients may suffer from disabling symptoms of hormone overproduction. Potentially curative surgery can be performed in patients with localized disease, and sometimes in patients with liver metastases. However, long-term follow-up of the latter patients mostly shows late tumour recurrences (Norton, 1994). Debulking (cytoreductive) surgery can be considered when most of the tumour burden can be excised safely to minimize hormonal symptoms and to facilitate medical therapy (McEntee et al, 1990;Carty et al, 1992;Que et al, 1995). An important question is whether the aggressive treatment of metastatic disease prolongs survival. No randomized studies are available today. Such studies are complicated by the lack of strict surgical treatment protocols running over long periods, the relatively low number of patients and the absence of a TNM (tumour, node, metastases) classification of these tumour types. Many clinical studies, in which debulking surgery and resection rates are discussed, are composed of patients with carcinoids and those with endocrine pancreatic tumours (EPT). However, these two disease entities may include tumours with markedly different biology.In our consecutive series of patients with advanced midgut carcinoids (all with locoregional and hepatic metastases) the estimated overall 5-year survival was 69% after active interventional treatment. The 5-year survival of carcinoid patients with bilobar liver metastases was 63% (cf. Wängberg et al, 1996). These figures are superior to the ones obtained after more conservative treatment. In a consecutive series of 42 patients with metastatic EPT from National Institutes of Health, the 5-year survival of those 17 patients resected for cure was 79% versus 28% in the non-resected group (Carty et al, 1992). Similar results were recently reported from the Mayo Clinic in 74 patients with hepatic metastases from either EPT or carcinoid tumours. The 4-year survival was 85% for one-third of the patients selected for resection versus 65% for the two-thirds non-resected (Que et al, 1995). In a recent French series of 34 patients with neuroendocrine tumours (carcinoids and EPT) and hepatic metastases, the liver resection rate was as high as 50%. Twelve of these 17 patients were operated upon with curative intent (Dousset et al, 1996).The aim of this retrospective study was to compare survival in our consecutive series of patients with malignant EPT with that of patients with advanced midgut carcinoids when subjected to similar treatment principles. Furthermore, EPT were staged according to the TNM classification of pancreatic carcinoma. By doing so, stage IV tumours should be compared with advanced carcinoid tumours with liver metastases.  Patients and treatmentThe 64 consecutive patients with advanced midgut carcinoids were treated during 1987-1997 (cf. Wängberg et al, 1996. All patients underwent primary surgery, removal of the primary tumo...

show abstract

“…At tumour progression, additional treatment with cytotoxic drugs was given (streptozotocin and 5-fluorouracil alternated with doxorubicin; cf. Moertel et al, 1994).…”

Section: Patients and Treatmentmentioning

confidence: 99%

mentioning

confidence: 99%

Comparison of survival between malignant neuroendocrine tumours of midgut and pancreatic origin

et al. 1999

View full text Add to dashboard Cite

show abstract

“…Debulking procedures offer palliation of hormonal symptoms and may prolong survival (McEntee et al, 1990;Ahlman et al, 2000). Palliative treatment may include chemotherapy and biotherapy with interferon, both with limited benefits and adverse effects (Ö berg, 1993;Moertel et al, 1994;Kölby et al, 2003). Following interventional and medical treatment, the 5-year survival is as high as 69% for patients with liver metastases Hellman et al, 2002).…”

mentioning

confidence: 99%

Successful receptor-mediated radiation therapy of xenografted human midgut carcinoid tumour

et al. 2005

View full text Add to dashboard Cite

Somatostatin receptor (sstr)-mediated radiation therapy is a new therapeutic modality for neuroendocrine (NE) tumours. High expression of sstr in NE tumours leads to tumour-specific uptake of radiolabelled somatostatin analogues and high absorbed doses. In this study, we present the first optimised radiation therapy via sstr using [ 177 Lu-DOTA 0 -Tyr 3 ]-octreotate given to nude mice xenografted with the human midgut carcinoid GOT1. The tumours in 22 out of 23 animals given therapeutic amounts showed dosedependent, rapid complete remission. The diagnostic amount (0.5 MBq [ 177 Lu-DOTA 0 -Tyr 3 ]-octreotate) did not influence tumour growth and was rapidly excreted. In contrast, the therapeutic amount (30 MBq [ 177 Lu-DOTA 0 -Tyr 3 ]-octreotate) induced rapid tumour regression and entrapment of 177 Lu so that the activity concentration of 177 Lu remained high, 7 and 13 days after injection. The entrapment phenomenon increased the absorbed dose to tumours from 1.6 to 4.0 Gy MBq À1 and the tumours in animals treated with 30 MBq received 120 Gy. Therapeutic amounts of [ 177 Lu-DOTA 0 -Tyr 3 ]-octreotate rapidly induced apoptosis and gradual development of fibrosis in grafted tumours. In conclusion, human midgut carcinoid xenografts can be cured by receptormediated radiation therapy by optimising the uptake of radioligand and taking advantage of the favourable change in biokinetics induced by entrapment of radionuclide in the tumours.

show abstract

“…The aggressive nature of these neoplasmsin the appendix and stomach has also been emphasized (1 1-13). Transarterial embolization (TAE) is often useful in the treatment of hepatic carcinoid tumors (2). The present patient was given chemotherapy because of the risk that the carcinoid syndrome would worsen.…”

Section: Discussionmentioning

confidence: 99%

“…Mixed carcinoid-adenocarcinoma is considered a highly aggressive neoplasm with a poor prognosis. Transarterial embolization (TAE) is often useful in the treatment of hepatic carcinoid tumors (2). The present patient Case Report…”

Section: Introductionmentioning

confidence: 99%

Mixed Carcinoid-Adenocarcinoma of the Liver.

et al. 2000

View full text Add to dashboard Cite

A 61-year-old man with a mixed carcinoid-adenocarcinoma of the liver is described. Microscopic examination of the lesion showed a differentiated adenocarcinoma with distinct carcinoid components that stained positively for argyrophil. Thetumor cells contained serotonin granules on immunohistochemical studies. Detailed examination disclosed no primary tumor in the gastrointestinal tract or in any other organ. Resection was considered impractical because there were multiple tumors. The patient received chemotherapy six times (cisplatin 60 mg/m2, epirubicin 40 mg/ m2 per month). The multiple tumors gradually shrank. At the time of this writing, the patient is still alive. To our knowledge, this is the first reported case of mixed carcinoid-adenocarcinoma of the liver. (Internal Medicine 39: 910-913, 2000)

show abstract

The Management of Patients with Advanced Carcinoid Tumors and Islet Cell Carcinomas

Abstract: Hepatic arterial occlusion can frequently produce major regression of neuroendocrine tumors with relief from the hormonal syndromes. Sequential chemotherapy may improve the rate and duration of the regression.

Cited by 276 publications

References 0 publications

Comparison of survival between malignant neuroendocrine tumours of midgut and pancreatic origin

Comparison of survival between malignant neuroendocrine tumours of midgut and pancreatic origin

Successful receptor-mediated radiation therapy of xenografted human midgut carcinoid tumour

Mixed Carcinoid-Adenocarcinoma of the Liver.

Contact Info

Product

Resources

About