The risk of metachronous cancers in patients with small-intestinal carcinoid tumors: a US population-based study

Abstract

Small-intestinal carcinoids (SIC) are the most common small-bowel malignancies. We sought to determine the risk of developing SIC before and after other primary malignancies (PM) and the prognosis of patients with SIC, with and without another PM. We used the Surveillance, Epidemiology, and End Results database to identify patients diagnosed with SICs between 1973 and 2007. Multiple primary-standardized incidence ratios were calculated as an approximation of relative risk (RR) to explore the association of SICs with metachronous malignancies. Survival analysis was performed using Kaplan-Meier methods and Cox proportional-hazard models. Among 8331 patients with SICs, 2424 (29%) had another PM at some time. The most common sites were prostate (26.2%), breast (14.3%), colon (9.1%), lung/bronchus (6.3%), and bladder (5.3%). Overall, 67% of patients had a PM diagnosed before SIC (pre-SIC), 33% after SIC (post-SIC), and 8% had a PM both before and after SIC. Among the pre-SIC group, the risk of future SIC was increased after cancers of the small bowel (RR 11.86 (95% CI: 6

The Risk of Second Primary Colorectal Adenocarcinomas Is Not Increased among Patients with Gastroenteropancreatic Neuroendocrine Neoplasms: A Nationwide Population-Based Study

“…Interestingly, they found an increased risk of metachronous SPMs in NET patients in a Taiwanese cohort. Similarly, a study using data from the Surveillance, Epidemiology, and End-Results (SEER) Program found an increased risk of developing metachronous second cancer after a diagnosis of small intestinal carcinoid [16]. These findings conflict with the findings of our study.…”

Evidence for a heritable contribution to neuroendocrine tumors of the small intestine

“…Carcinoids are rare neuroendocrine tumors; 67% occur in the gastrointestinal tract, primarily in the small intestine (Amin et al 2012; Kharazmi et al 2013) (Modlin, et al 2003). Carcinoid tumors of the small intestine, presently called small intestinal neuroendocrine tumors (SI-NETs) derive from enterochromaffin cells of the neuroendocrine system in the gut and during development, originate from the same stem cells as the rest of the gut epithelium (not neural crest).…”

“…These cells contain a large amount of the body’s store of serotonin and, in response to stimuli in the lumen (chemical, mechanical, pathological), the release of serotonin regulates gut motility and secretion as well as triggering nausea signals to the brain. SI-NETs comprise approximately 40% of all small intestinal primary tumors and are similar in frequency to adenocarcinomas of the small intestine (Amin et al 2012; Kharazmi et al 2013). Incidence of SI-NETS is 0.9 per 100,000 population per year with the rate steadily increasing over the past 30 years (Amin et al 2012; Kharazmi et al 2013).…”

“…SI-NETs comprise approximately 40% of all small intestinal primary tumors and are similar in frequency to adenocarcinomas of the small intestine (Amin et al 2012; Kharazmi et al 2013). Incidence of SI-NETS is 0.9 per 100,000 population per year with the rate steadily increasing over the past 30 years (Amin et al 2012; Kharazmi et al 2013). …”

“…Cigarette smoking and alcohol are associated with an elevated odds ratio (5.8 and 4.4 respectively) (Amin et al 2012; Kharazmi et al 2013). Much of what is known about familial contribution of SI-NETs has come from the Nordic population databases going back to the 1950’s and looking at first-degree relationships.…”