Therapeutic Options for Patients With Metastatic Gastrointestinal Carcinoid

摘要

Carcinoid tumors are estimated to occur in 1-2 per 100,000 people and account for about 0.5% of all malignancies. The term "karzinoid" was coined by Oberndorfer in 1907 to describe a tumor that resembled an adenocarcinoma, yet behaved in a more benign fashion. Thorson was the first to describe the clinical "carcinoid syndrome" in 1954, and Lembeck later identified serotonin as the major hormone responsible for this syndrome. The majority of carcinoids are found in the gastrointestinal (GI) tract (67.5%). Within the GI tract the most common locations are the small bowel (25%), rectum (14%), and appendix (12%). The treatment of choice for carcinoid tumors is surgical resection when possible. However, approximately 75% of patients with carcinoids will present with metastatic disease. Interestingly, carcinoid and other neuroendocrine tumors are the second most common cause of isolated hepatic metastases after colorectal cancer.Currently, there are no randomized, prospective trials regarding the optimal treatment of patients with metastatic carcinoid tumors, including those with isolated hepatic metastases. Thus, large institutional experiences have been central to defining the role of surgery and other modalities in managing these patients with metastatic disease. In the featured manuscript, Landry et al. from the University of Louisville provide further evidence that aggressive surgical management of carcinoid hepatic metastases may benefit patients with this disease