title: Surgery as primary treatment in patients with liver metastases from carcinoid tumors: a retrospective, unicentric study over 13 years.
abstract: BACKGROUND
  The heterogeneous nature of carcinoid tumors makes it difficult to develop a standardized treatment strategy for the primary tumor itself and for probable liver metastases. However, prolongation of the 5-year survival rate (5-ysr) and amelioration of the incapacitating symptoms after resection of the primary tumor and its metastases demonstrate that surgical intervention must be the treatment of choice in these tumors.
  
  
  METHODS
  The data of 31 patients (17 patients with midgut carcinoids, 10 patients with an endocrine carcinoma (carcinoid) of the pancreas, and 4 patients with carcinoids of the lung) who underwent liver operation for metastatic carcinoid tumors between 1983 and 1996 were analyzed, with special regard to factors influencing postoperative survival.
  
  
  RESULTS
  Ten patients underwent curative resection (5-ysr, 86%), and palliative operations were performed in 21 patients (5-ysr, 26%). The overall 5-ysr was 47%, with a mean postoperative follow-up of 3.5 years (range, 4 months to 10.8 years). Postoperative morbidity rate was 13%. Size of liver metastases, radicality of the operation and localization of the primary tumor were factors influencing postoperative survival.
  
  
  CONCLUSIONS
  Surgery for metastatic carcinoid tumors may be curative or palliative, with a potential for cure in some cases and prolongation of survival and amelioration of symptoms in the majority of patients.
authors.affiliation: Clinic of Visceral and Transplantation Surgery, Hannover Medical School, Hannover, Germany.
authors.forename: H
authors.initials: H
authors.lastname: Nave
authors.forename: E
authors.initials: E
authors.lastname: Mössinger
authors.forename: H
authors.initials: H
authors.lastname: Feist
authors.forename: H
authors.initials: H
authors.lastname: Lang
authors.forename: H
authors.initials: H
authors.lastname: Raab
mesh_terms: D000328:Adult; D000368:Aged; D002276:Carcinoid Tumor / Q000556:secondary* / Q000601:surgery; D003131:Combined Modality Therapy; D005770:Gastrointestinal Neoplasms / Q000473:pathology; D006801:Humans; D008113:Liver Neoplasms / Q000556:secondary* / Q000601:surgery; D008175:Lung Neoplasms / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D011788:Quality of Life; D012189:Retrospective Studies; D012307:Risk Factors; D016019:Survival Analysis