Carcinoid tumors of the gastrointestinal tract

Carcinoid tumors continue to be of specific clinical interest because of their diverse presentation, hormonal secretion, and malignant potential. One hundred ninety-two patients with carcinoid tumors were treated at the University of Iowa Hospitals and Clinics between 1938 and 1982. The most common location of these tumors was the appendix (30%), followed by the ileum (23%) and rectum (9%). Metastatic disease occurred in 29 per cent of all patients, with colonic and ileal tumors being the most likely to metastasize (40% and 35%, respectively). Surgical excision continues to be the treatment of choice in resectable tumors. Appendectomy alone proved effective in the treatment of appendiceal tumors less than 2 cm in diameter and without lymph node metastases. Local excision was also sufficient for the treatment of rectal tumors less than 2 cm in diameter and without invasion of the muscularis propria. Ileal, colonic, and locally advanced appendiceal and rectal tumors should be treated with radical excision including resection of the regional lymph nodes. The overall 5-year survival rate was 47%. Patients with metastatic disease had a lower survival rate (25%) compared with patients without metastases (64%).