Carcinoid tumors of the colon. A study of 72 patients

Since carcinoid tumors rarely originate in the colon (excluding those that arise in the appendix and rectum), there are few large clinical series describing these neoplasms. Seventy-two patients with colonic carcinoids treated over a 40 year period have been reviewed. The peak incidence was in the seventh decade and females outnumbered males 2:1. Virtually all patients were symptomatic, usually complaining of abdominal pain. The symptom duration averaged 3.6 months. Thirty-eight percent of patients had masses in the right lower quadrant and 16 percent, hemoccult-positive stools. Three patients had a documented elevation of the urinary 5-HIAA level. Nearly 70 percent of the lesions were situated in the right segment of the colon. Barium enemas usually detected the neoplasms. Most patients had colon resections and five had resection of adjacent organs. Forty-four percent of the lesions had spread to regional sites and 38 percent to distant points. Most lesions were bulky. The operative mortality was 19 percent overall. Chemotherapy and radiotherapy did not appear to provide good palliation. Synchronous or metachronous neoplasms developed in 30 patients, especially in the colon, during the period of follow-up. The crude survival rates were 58, 51, 25 and 10 percent at 1, 2, 5, and 10 years, respectively.