Surgical therapy for small-bowel carcinoid tumors

Area of Science:

• Gastroenterology
• Surgical Oncology
• Endocrinology

Background:

• Carcinoid tumors of the small intestine are rare neuroendocrine neoplasms.
• Symptomatic presentation often includes weight loss, diarrhea, and bowel obstruction.
• Carcinoid syndrome affects a significant portion of patients.

Purpose of the Study:

• To evaluate the clinical features, management, and prognostic factors of small intestine carcinoid tumors.
• To determine the impact of surgical intervention on patient survival.
• To identify key indicators for predicting outcomes in these patients.

Main Methods:

• Retrospective analysis of 82 symptomatic patients with small intestine carcinoid tumors treated over 20 years.
• Inclusion of clinical data, surgical procedures, and follow-up information.
• Statistical analysis to identify prognostic variables.

Main Results:

• Common symptoms included weight loss, diarrhea, and obstruction; 30% had carcinoid syndrome.
• Hepatic metastases were present in 37% of patients; 28% had multiple tumors.
• Overall mortality was 7%, with a 5-year survival rate of 59%.
• Hepatic metastases and incomplete resection were significant negative prognostic factors.
• Patient age, sex, and primary tumor size did not impact prognosis.

Conclusions:

• Surgical resection, including regional lymph nodes, is recommended for all patients with small intestine carcinoid tumors.
• Early detection and complete resection are vital for improving patient outcomes.
• Prognosis is primarily determined by the presence of hepatic metastases and the completeness of surgical resection.