Interventional treatment of carcinoid tumors of the small bowel and the colon

B. Wängberg, O. Nilsson, Ulf Tylen, H. Ahlman

Research output: Contribution to journalArticle

2 Scopus citations

Abstract

The long-term survival of patients with small bowel carcinoids and hepatic metastases has been discouragingly low. A minority of patients can reach a stage of anatomical and biochemical cure by surgery alone. Recurrent subclinical disease can be diagnosed using somatostatin receptor scintigraphy. In patients with bilobar hepatic disease, embolization of the hepatic arteries subsequent to the primary surgical treatment is a low-risk procedure which, in combination with octreotide treatment, seems to increase the 5-year survival rate markedly and relieve hormonal symptoms. The therapeutic effect of embolizations can be monitored radiologically and biochemically by tumor markers, e.g. 5-hydroxyindoleacetic acid (5-HIAA). The acute response to embolization seems to be related to the degree of activation of natural killer cells in peripheral blood which reflects systemic antitumor response. Appendix carcinoids on the other hand have a good prognosis which is related to tumor size and invasiveness. Colonic carcinoids again have a worse prognosis and can be classified according to a modified Duke's classification. For both appendix and colonic carcinoids the cut-off point for more extensive surgical procedures is a diameter exceeding 2 cm.

Original languageEnglish (US)
Pages (from-to)292-297
Number of pages6
JournalChirurgische Gastroenterologie mit Interdisziplinaren Gesprachen
Volume13
Issue number4
StatePublished - Dec 1997
Externally publishedYes

Keywords

  • Carcinoid tumors
  • Colon
  • Embolization
  • Hepatic arteries
  • Small intestine

ASJC Scopus subject areas

  • Gastroenterology
  • Surgery

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