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Survival and Clinical Characteristics in 284 Patients with Malignant Midgut Carcinoid Tumors
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences.
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URN: urn:nbn:se:uu:diva-95342OAI: oai:DiVA.org:uu-95342DiVA: diva2:169517
Available from: 2007-01-19 Created: 2007-01-19 Last updated: 2012-02-20
In thesis
1. Midgut Carcinoid Tumours: New Diagnostic Procedures and Treatment
Open this publication in new window or tab >>Midgut Carcinoid Tumours: New Diagnostic Procedures and Treatment
2007 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Midgut carcinoid tumours are rare with an incidence of 0.5-2.1/100 000. The primary tumour is usually small and grows slowly but has almost always set metastases at diagnosis. When radically operated, most patients will eventually recur in their disease.

We evaluated different methods in detecting recurrent disease in 61 malignant midgut carcinoid tumours that had been radically operated. Thirty-eight patients have been diagnosed with a recurrence. In 32/38 of these patients P-Chromogranin A was the first method to indicate a recurrence. We therefore recommend using P-CgA in the work up in these patients.

We investigated characteristics, survival and independent factors that could be of bad prognostic value. We found that in our 284 malignant midgut carcinoid tumours, 208/284 (73%) had distant metastases and 30/284 (11%) had carcinoid heart disease. Median survival was 115.5 months and five-year survival was 77%. In a multivariate analysis liver metastases and carcinoid heart disease were poor prognostic factors.

We performed a phase II study with octreotide pamoate investigating the clinical effect in 12 malignant midgut carcinoid tumours in a progressive phase. We found that 9/12 (75%) were stabilised for a median duration of 12 months. We think that this is a good effect considering the advanced stage.

We investigated the frequency of four different tyrosine kinase receptors, platelet derived growth factor receptor (PDGR) α and β, epidermal growth factor receptor (EGFR) and c-kit, in 36 malignant midgut carcinoid tumours with immunohistochemistry. We found that 13/34 (38%) tumour samples expressed PDGFRα, 29/33 (88%) PDGFRβ, 24/33 (73%) EGFR, whereas none expressed c-kit. This implicates that midgut carcinoid tumours might be susceptible to treatment with tyrosine kinase receptor inhibitors.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2007. 53 p.
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 216
Medicine, Midgut carcinoid tumour, Chromogranin A, Carcinoid heart disease, Survival, Octreotide pamoate, Tyrosine kinase receptors, Platelet derived growth factor receptor, Epidermal growth factor receptor, Medicin
urn:nbn:se:uu:diva-7436 (URN)978-91-554-6773-9 (ISBN)
Public defence
2007-02-09, Enghoffsalen, Ing 50 bv, Akademiska sjukhuset, Uppsala, 13:15
Available from: 2007-01-19 Created: 2007-01-19Bibliographically approved

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