MANAGEMENT OF CARCINOID TUMORS OF GASTROINTESTINAL-TRACT

Abstract

Sixty-five patients seen between 1951 and 1974 with carcinoid tumors of the gastrointestinal tract were reviewed. Sixty-two patients were operated upon and only 1 carcinoid was discovered for the 1st time at autopsy. Although corrected actual 5 and 10 yr surrvival rates of more than 60% were attained, only 1 of 15 patients was alive 5 yr after the discovery of liver metastases. Patients less than 60 yr of age, with tumors of less than 0.5 cm in diameter and with no history of weight loss, survived best. Most rectal and appendiceal carcinoids were small and there were no deaths in patients who had undergone local resection. Only 33% of the patients with small intestinal carcinoids survived for 5 yr; none survived for more than 1 yr after diagnosis of the carcinoid syndrome was made. All colonic carcinoids had metastasized by the time the operation was performed. Carcinoids of less than 0.5 cm in diameter located anywhere in the gastrointestinal tract can be managed by simple local resection. Tumors 1 cm in diameter warrant consideration of a more extensive operation. A radical excision usually is required for tumors of more than 2 cm in diameter, even in the presence of metastatic disease.