Carcinoid syndrome natural history, complications and prognosis: Difference between revisions
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==Prognosis== | ==Prognosis== | ||
Prognosis is generally good, and the 5-year survival rate of patients with carcinoid syndrome is approximately 69.7%. | Prognosis is generally good, and the 5-year survival rate of patients with carcinoid syndrome is approximately 69.7%.<ref name="pmid15213627">{{cite journal| author=Maggard MA, O'Connell JB, Ko CY| title=Updated population-based review of carcinoid tumors. | journal=Ann Surg | year= 2004 | volume= 240 | issue= 1 | pages= 117-22 | pmid=15213627 | doi= | pmc=PMC1356383 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15213627 }} </ref> | ||
*Factors that determine the | *Factors that determine the prognosis of patients with gastrointestinal carcinoid tumors include:<ref>{{Cite web | title =Prognostic Factors| url =http://www.cancer.gov/types/gi-carcinoid-tumors/hp/gi-carcinoid-treatment-pdq }}</ref> | ||
:*Site of origin | |||
:* | :*Size of the primary tumor | ||
:* | :*Anatomical extent of disease | ||
:* | *Elevated expression of the proliferation antigen Ki-67 and the tumor suppressor protein ''p53'' have been associated with poorer prognosis. | ||
*Elevated expression of the proliferation antigen Ki-67 and the tumor suppressor protein p53 have been associated with poorer prognosis. | *Negative prognostic factors include: | ||
* | **Carcinoid heart disease | ||
**High concentrations of the tumor markers - urinary [[5-HIAA]] and plasma [[chromogranin A]]. | |||
**Metastasis to the liver | |||
**Carcinoid tumor of the thymus | |||
* | *Prognosis is better with new treatment methods such as [[sandostatin]]. | ||
* | |||
==References== | ==References== | ||
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Parminder Dhingra, M.D. [2]
Overview
The presence of liver metastasis is associated with a particularly poor prognosis among patients with carcinoid tumor. Depending on the extent of the tumor at the time of diagnosis, the prognosis may vary. However, the prognosis is generally regarded as poor. Common complications of carcinoid tumor include gastrointestinal bleeding, right heart failure, bowel obstruction, hypotension, and tricuspid insufficiency and pulmonary stenosis.
Natural History
- They have a very slow growth rate compared to most malignant tumors.
- Carcinoid heart disease develops in more than one-third of patients with carcinoid syndrome. Pathologically, the cardiac valves become thickened because of fibrosis, and the tricuspid and pulmonic valves are affected to a greater extent than the mitral and aortic valves.
Complications
Common complications of carcinoid tumor include:
- Increased risk of falls and injury (from hypotension)
- Bowel obstruction (from tumor)
- Gastrointestinal bleeding
- Right heart failure
- Serotonin causes fibrosis of the tricuspid valve and pulmonary valve, more rarely the mitral valve in cases with left sided involvement
- "TIPS" - Tricuspid Insufficiency, Pulmonic Stenosis (fibrosis of tricuspid and pulmonary valves)
Prognosis
Prognosis is generally good, and the 5-year survival rate of patients with carcinoid syndrome is approximately 69.7%.[1]
- Factors that determine the prognosis of patients with gastrointestinal carcinoid tumors include:[2]
- Site of origin
- Size of the primary tumor
- Anatomical extent of disease
- Elevated expression of the proliferation antigen Ki-67 and the tumor suppressor protein p53 have been associated with poorer prognosis.
- Negative prognostic factors include:
- Carcinoid heart disease
- High concentrations of the tumor markers - urinary 5-HIAA and plasma chromogranin A.
- Metastasis to the liver
- Carcinoid tumor of the thymus
- Prognosis is better with new treatment methods such as sandostatin.
References
- ↑ Maggard MA, O'Connell JB, Ko CY (2004). "Updated population-based review of carcinoid tumors". Ann Surg. 240 (1): 117–22. PMC 1356383. PMID 15213627.
- ↑ "Prognostic Factors".