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Metastatic proclivities and patterns among APUD cell neoplasms
1Department of Surgery, University of Miami School of Medicine, FL 33101.
Seminars in Surgical Oncology
|September 1, 1993
Summary
Neoplasms of APUD cell origin vary in metastasis. Aggressive surgery offers disease-free survival for some patients with these neuroendocrine tumors, even with advanced disease.
Area of Science:
- Oncology
- Endocrinology
- Pathology
Background:
- APUD cell-derived neoplasms exhibit diverse metastatic behaviors.
- Pituitary and parathyroid tumors rarely metastasize, unlike oat cell lung cancers and melanomas.
- Predicting metastasis in carcinoids, islet cell tumors, and paragangliomas is challenging due to lack of reliable histological markers.
Purpose of the Study:
- To review the metastatic behavior of APUD cell-derived neoplasms.
- To highlight the challenges in predicting dissemination risk.
- To emphasize the prognostic implications of metastatic disease and the role of surgical intervention.
Main Methods:
- Literature review of APUD cell neoplasms.
- Analysis of metastatic patterns and prognostic factors.
- Evaluation of treatment outcomes, particularly surgical resection.
Main Results:
- Metastatic potential varies significantly among APUD cell tumors.
- No reliable histological markers currently predict lymphatic or hematogenous spread.
- Unresectable distant metastases, especially to the liver, indicate a poor prognosis.
- Mortality is primarily linked to tumor growth and metastasis rather than endocrinopathies.
Conclusions:
- Aggressive surgical resection (curative or debulking) is recommended.
- Worthwhile clinical disease-free survival can be achieved in select patients.
- Understanding metastatic behavior is crucial for managing these neuroendocrine tumors.