Prognostic clinicopathologic factors in longitudinally followed patients with metastatic small bowel carcinoid tumors

Thomas Curran, Sheryl Tulin-Silver, Kalpesh Patel, Stephen Ward, Melissa Schneiderman, Noam Harpaz, Myron Schwartz, Steven Itzkowitz, Richard R.P. Warner, Michelle Kang Kim

Research output: Contribution to journalArticlepeer-review

12 Scopus citations

Abstract

Objectives: Neuroendocrine tumors demonstrate heterogeneous behavior based on the site of origin and histology. This study aimed to delineate prognostic clinicopathologic features in patients with metastatic midgut carcinoid. Methods: All patients underwent resection of the primary tumor in the setting of metastatic disease. Survival was measured from the date of primary tumor resection and calculated by Kaplan-Meier estimation. Clinical data include age, sex, serum biomarkers, primary tumor size, Ki-67 index, and the performance of hepatic cytoreductive procedure. Serially collected serum biomarkers were considered as mean values within periods relative to primary resection: preoperative, 0 to 1 year postoperative, and years 1 to 5 postoperative. Log-rank comparisons were used to assess the prognostic value of the aforementioned features. Results: Forty-nine patients (21 men) with metastatic midgut carcinoid who underwent primary tumor resection were identified. Median survival was 121 months. The overall 5-year survival rate was 83%. Age higher than 65 years (P = 0.01) and late postoperative chromogranin A (CgA; P = 0.02) were associated with decreased survival. Conclusions: This study highlights the favorable prognosis of patients with metastatic small bowel carcinoid in a multidisciplinary treatment program. Among other factors, elevated postoperative CgA is associated with decreased survival. The significance of increased CgA over time underlies the importance of longitudinal follow-up for these patients.

Original languageEnglish
Pages (from-to)1253-1257
Number of pages5
JournalPancreas
Volume40
Issue number8
DOIs
StatePublished - Nov 2011

Keywords

  • carcinoid
  • chromogranin
  • metastatic
  • neuroendocrine
  • small bowel
  • tumor

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