Surgery as primary treatment in patients with liver metastases from carcinoid tumors: A retrospective, unicentric study over 13 years

Background. The heterogeneous nature of carcinoid tumors makes it difficult to develop a standardized treatment strategy for the primary tumor itself and for probable liver metastases. However, prolongation of the 5-year survival rate (5-ysr) and amelioration of the incapacitating symptoms after res...

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Bibliographic Details
Published in:Surgery 2001-02, Vol.129 (2), p.170-175
Main Authors: Nave, Heike, Mössinger, Eckart, Feist, Henning, Lang, Hauke, Raab, Hans-Rudolf
Format: Article
Language:English
Subjects:
Adult
Aged
Biological and medical sciences
Carcinoid Tumor - secondary
Carcinoid Tumor - surgery
Combined Modality Therapy
Gastrointestinal Neoplasms - pathology
Humans
Liver Neoplasms - secondary
Liver Neoplasms - surgery
Liver, biliary tract, pancreas, portal circulation, spleen
Lung Neoplasms - pathology
Male
Medical sciences
Middle Aged
Neoplasm Metastasis
Quality of Life
Retrospective Studies
Risk Factors
Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
Surgery of the digestive system
Survival Analysis
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Summary:Background. The heterogeneous nature of carcinoid tumors makes it difficult to develop a standardized treatment strategy for the primary tumor itself and for probable liver metastases. However, prolongation of the 5-year survival rate (5-ysr) and amelioration of the incapacitating symptoms after resection of the primary tumor and its metastases demonstrate that surgical intervention must be the treatment of choice in these tumors. Methods. The data of 31 patients (17 patients with midgut carcinoids, 10 patients with an endocrine carcinoma (carcinoid) of the pancreas, and 4 patients with carcinoids of the lung) who underwent liver operation for metastatic carcinoid tumors between 1983 and 1996 were analyzed, with special regard to factors influencing postoperative survival. Results. Ten patients underwent curative resection (5-ysr, 86%), and palliative operations were performed in 21 patients (5-ysr, 26%). The overall 5-ysr was 47%, with a mean postoperative follow-up of 3.5 years (range, 4 months to 10.8 years). Postoperative morbidity rate was 13%. Size of liver metastases, radicality of the operation and localization of the primary tumor were factors influencing postoperative survival. Conclusions. Surgery for metastatic carcinoid tumors may be curative or palliative, with a potential for cure in some cases and prolongation of survival and amelioration of symptoms in the majority of patients. (Surgery 2001;129:170-5.)
ISSN:0039-6060
1532-7361
DOI:10.1067/msy.2001.110426