[Surgical and adjuvant therapy of neuroendocrine tumors of the gastrointestinal tract and their metastases. A retrospective analysis of personal patient group].
BACKGROUND
Carcinoid tumors are the most common neuroendocrine tumors of the gastrointestinal tract. Surgical treatment and prognosis depend on the location of the tumor.


METHODS
Between 01.01.1985 and 31.12.1999 25 patients with neuroendocrine tumors of the gastrointestinal tract or their metastases were treated in our institution. The records of these patients were reviewed retrospectively. Patients still alive were reexamined clinically.


CONCLUSIONS
The most frequent primary sites were the ileum and jejunum (36%), appendix (36%), stomach (12%), pancreas (8%), colon (4%) and bronchus with hepatic metastasis (4%). A malignant carcinoid syndrome was present in 8 patients. In patients with neuroendocrine tumors, curative, radical tumor removal should be attempted. Some patients with advanced disease needed some surgery for tumor debulking and resection of metastases. In non-resectable liver metastases hepatic arterial chemotherapy and chemoembolization after implantation of port catheters seem to be very beneficial therapeutic options. A fixed part of the therapeutic regime in progressive disease is adjuvant chemotherapy with 5-fluorouracil and streptozotocin and symptomatic therapy with octreotide.
Schmidbauer
S
S
Chirurgische Klinik und Poliklinik, Klinikum Innenstadt der Ludwig-Maximilians-Universität München.
Ladurner
R
R
Jückstock
H
H
Trupka
A W
AW
Mussack
T
T
Hallfeldt
K K
KK
D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D016461:Chemoembolization, Therapeutic; D017024:Chemotherapy, Adjuvant; D003131:Combined Modality Therapy; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage / Q000009:adverse effects; D005500:Follow-Up Studies; D005770:Gastrointestinal Neoplasms / Q000188:drug therapy / Q000601:surgery*; D006801:Humans; D008113:Liver Neoplasms / Q000188:drug therapy / Q000556:secondary* / Q000601:surgery; D008297:Male; D008303:Malignant Carcinoid Syndrome / Q000188:drug therapy / Q000601:surgery; D008875:Middle Aged; D018358:Neuroendocrine Tumors / Q000188:drug therapy / Q000556:secondary* / Q000601:surgery; D015282:Octreotide / Q000008:administration & dosage / Q000009:adverse effects; D012189:Retrospective Studies; D013311:Streptozocin / Q000008:administration & dosage / Q000009:adverse effects; D016896:Treatment Outcome
D000970:Antineoplastic Agents; D013311:Streptozocin; D015282:Octreotide; D005472:Fluorouracil