title: Management of disseminated midgut carcinoid tumours.
abstract: Forty-one patients with disseminated midgut carcinoid tumours were treated over a 6-year period according to a strict programme including primary surgical treatment. In 10 patients, a total remission of the disease was obtained. Patients with bilobar hepatic disease had ischaemic treatment of their liver metastases by hepatic arterial embolisation after primary surgical and medical treatment (low dose octreotide). Thus, by combining surgical, radiological and medical treatment modalities, we wanted to offer these patients optimal palliation. This treatment programme resulted in good symptomatic relief in all patients accompanied by a marked reduction in 5-hydroxyindoleacetic acid (5-HIAA) levels. At recurrence of symptoms in combination with rising 5-HIAA levels, embolisation was repeated. Ten of the treated patients have deceased during the observation period, but only 5 from their carcinoid disease.
authors.affiliation: Department of Surgery, Sahlgrenska Hospital, University of Göteborg, Sweden.
authors.forename: H
authors.initials: H
authors.lastname: Ahlman
authors.forename: B
authors.initials: B
authors.lastname: Wängberg
authors.forename: S
authors.initials: S
authors.lastname: Jansson
authors.forename: O
authors.initials: O
authors.lastname: Stenqvist
authors.forename: K
authors.initials: K
authors.lastname: Geterud
authors.forename: U
authors.initials: U
authors.lastname: Tylén
authors.forename: K
authors.initials: K
authors.lastname: Caidahl
authors.forename: T
authors.initials: T
authors.lastname: Scherstén
authors.forename: L E
authors.initials: LE
authors.lastname: Tisell
mesh_terms: D000328:Adult; D000368:Aged; D002276:Carcinoid Tumor / Q000188:drug therapy / Q000556:secondary / Q000601:surgery / Q000628:therapy*; D003131:Combined Modality Therapy; D004621:Embolization, Therapeutic; D005260:Female; D006498:Hepatectomy; D006801:Humans; D006897:Hydroxyindoleacetic Acid / Q000032:analysis; D007414:Intestinal Neoplasms / Q000188:drug therapy / Q000601:surgery / Q000628:therapy*; D008113:Liver Neoplasms / Q000556:secondary / Q000628:therapy; D008207:Lymphatic Metastasis; D008297:Male; D008303:Malignant Carcinoid Syndrome / Q000188:drug therapy / Q000601:surgery / Q000628:therapy*; D008875:Middle Aged; D015282:Octreotide / Q000008:administration & dosage / Q000627:therapeutic use*; D010166:Palliative Care; D012878:Skin Neoplasms / Q000556:secondary / Q000628:therapy
chemical_list: D006897:Hydroxyindoleacetic Acid; D015282:Octreotide