Recent aspects in diagnosis, treatment and follow-up in a series of 116 carcinoid tumors of the gastrointestinal tract
P. Bobotsi1, A. Kolindou2, S. Tseleni-Balafouta3, E. Mallas4, G.C. Nikou1, C. Toubanakis1, P. Nikolaou
Aim of the study: We present in this study our diagnostic
and therapeutical approach in a series of 116 patients (pts)
with carcinoid tumors originating from the Gastrointestinal
(GI) tract and pancreas, in parallel with a brief review
of the literature.
Methodology: One hundred and sixteen (75 females and 41
males, aged from 16 to 85 years) pts were included.The diagnosis
was confirmed histologically. Pts were evaluated
several times per year with clinical, biochemical and imaging
assesments, including neuroendocrine markers
[Chromogranin-A(CgA),5-HIAA] and OCTREOSCAN. The
follow-up period ranged between 1.5 to 12.5 years (mean
time: 5 years and 3 months) and it is still in progress.
Results: Pts symptoms depended mainly on the location of
the primary tumors and the existence or not of metastases.
CgA and 5-HIAA levels were increased especially in metastatic
tumors. OCTREOSCAN was positive in 94% pts with
metastatic disease. The majority of pts underwent a surgical
resection of the primary tumor, while in 18%, an endoscopic
polypectomy was performed. Somatostatin analogues
when used, resulted in control of symptoms (71%), stabilization
of tumor growth (66%) or tumor shrinkage (8.5%).
Conclusions: a) Tumor size and dispersion of disease highly
predict the evolution of pts b) serum Chromogranin-A
seems to be a very useful tumor marker c) OCTREOSCAN
contributes to the better localization of the primary tumors
and their metastases d) surgery is the treatment of choice
in non-metastatic tumors and, is recommended when possible,
in already metastatic ones and e) in metastatic disease,
Somatostatin analogues improve the pts quality of
life and result in stabilization of disease in most cases. The
results of most studies are in agreement with our experience.
Key words: Carcinoid tumors,Chromograninn -A, Somatostatin
Receptor Scintigraphy, carcinoid syndrome, surgical
excision, Somatostatin analogues, neuroendocrine tumors.