CA: A Cancer Journal for Clinicians, Vol 18, 212-218, Copyright
© 1968 by American Cancer Society
Gastrointestinal Carcinoids and the Carcinoid Syndrome: Clinical Characteristics and Therapy
Bennett L. Crowder II M.D.1,
Edward S. Judd M.D.2, and
Malcolm B. Dockerty M.D.3
1 Resident in Surgery, Mayo Graduate School of Medicine, University of Minnesota, Rochester, Minnesota.
2 Consultant in Section of Surgery, Mayo Clinic and Professor of Surgery, Mayo Graduate School of Medicine, University of Minnesota.
3 Consultant in Section of Surgical Pathology, Mayo Clinic and Professor of Pathology, Mayo Graduate School of Medicine, University of Minnesota.
At any location in the gastrointestinal tract, the tumor is usually asymptomatic when less than 1.0 cm. in diameter. Lesions from 1.0 to 2.0 cm. in size produce nodal metastasis in 30 to 50 percent of cases, and lesions greater than 2.0 cm. in size have nodal metastasis in 80 to 90 percent of the cases. Any carcinoid tumor greater than 1.0 cm. in diameter—especially if clinical symptoms are present—should be treated by a definitive cancer operation with special attention to the regional lymph nodes.
Radiotherapy does little good. Chemotherapy may be of value in some cases, but at present is still investigational. Pharmacologic agents have small effect on the carcinoid syndrome. The treatment of choice is surgery—judicious and aggressive—aimed at the removal of all tumorous tissue. The resection of hepatic metastases is of value in some patients who exhibit the carcinoid syndrome. Relief of intestinal obstruction may add many months to the life of patients with advanced carcinoid disease.
