title: Carcinoid tumors: analysis of prognostic factors and survival in 301 patients from a referral center.
abstract: BACKGROUND
  Little is known about factors related to prognosis in patients with carcinoid disease. In this study we have tried to identify such factors.
  
  
  METHODS
  We have evaluated 301 consecutive carcinoid patients (256 midgut, 39 foregut and six hindgut) referred during 15 years for medical treatment with respect to tumor distribution, hormone production, prognostic factors and survival.
  
  
  RESULTS
  Survival was significantly shorter in midgut carcinoid patients with > or = 5 liver metastases or with high levels of urinary 5-hydroxyindoleacetic acid, plasma chromogranin A or neuropeptide K. By univariate analysis, these variables together with the presence of carcinoid syndrome were related to a higher risk of dying. In multivariate analyses, performed in the 71 patients with full information on all variables, advanced age and plasma chromogranin A > 5000 micrograms/l were independent predictors of overall survival.
  
  
  CONCLUSIONS
  Poor prognostic factors for midgut carcinoid patients were multiple liver metastases, presence of carcinoid syndrome and high levels of the tumor markers studied. In this study the only independent predictors of bad prognosis in midgut, carcinoid patients were advanced age, which however is inherently related to overall survival, and plasma chromogranin A > 5000 micrograms/l. Thus, chromogranin A may prove to be an important prognostic marker for patients with carcinoid tumors.
authors.affiliation: Department of Internal Medicine, University Hospital, Uppsala University, Sweden.
authors.forename: E T
authors.initials: ET
authors.lastname: Janson
authors.forename: L
authors.initials: L
authors.lastname: Holmberg
authors.forename: M
authors.initials: M
authors.lastname: Stridsberg
authors.forename: B
authors.initials: B
authors.lastname: Eriksson
authors.forename: E
authors.initials: E
authors.lastname: Theodorsson
authors.forename: E
authors.initials: E
authors.lastname: Wilander
authors.forename: K
authors.initials: K
authors.lastname: Oberg
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D014408:Biomarkers, Tumor / Q000378:metabolism; D002276:Carcinoid Tumor / Q000378:metabolism / Q000401:mortality* / Q000473:pathology; D053379:Chromogranin A; D002864:Chromogranins / Q000378:metabolism; D005260:Female; D005770:Gastrointestinal Neoplasms / Q000378:metabolism / Q000401:mortality* / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009479:Neuropeptides / Q000378:metabolism; D011379:Prognosis; D016019:Survival Analysis; D015320:Tachykinins
chemical_list: D014408:Biomarkers, Tumor; D053379:Chromogranin A; D002864:Chromogranins; D009479:Neuropeptides; D015320:Tachykinins; C045206:neuropeptide K