[Clinical review of gastrointestinal carcinoid tumor and analysis of the factors predicting metastasis].
OBJECTIVE
Carcinoid tumors are submucosal tumors with metastatic potential. We tried to determine the clinical course of gastrointestinal (GI) carcinoid tumors and find the factors predicting metastasis.


METHODS
We reviewed the clinical records of 81 cases with GI carcinoid tumors. Involved organ, age, sex, symptoms, treatments, and metastatic patterns were reviewed. We evaluated the macroscopic and microscopic parameters to predict the metastatic potential of GI carcinoid tumors.


RESULTS
The common sites of GI carcinoids were rectum (71.7%), stomach (13.6%), and duodenum (8.6%). Mean age of the patients was 49 years old with a peak incidence of sixth decade. Male to female ratio was 1.38:1. Most symptoms were usually nonspecific. Fifty five patients (67.9%) received endoscopic treatments while 23 patients (28.4%) received surgical treatment. Patients were followed up for a mean period of 15.6 months. There were 10 cases (12.3%) of metastasis. There were significantly more metastasis in patients with tumor size>10 mm (p<0.001), central depression or ulcer (p=0.009) in macroscopic parameter, and with invasion below submucosa, lymphatic or venous invasion, number of mitosis>2, or Ki-67 labeling index>2 in microscopic parameter (p<0.05). Independent factors predicting metastasis were tumor size and central depression or ulcer in multivariate analysis (p=0.002 and p=0.035, respectively).


CONCLUSIONS
Patients with tumor size>10 mm, central depression or ulcer, invasion below submucosa, lymphatic or venous invasion, mitosis>2, and Ki-67 labeling index>2 have higher metastatic potential. Those with risk factors predicting metastasis should be treated and followed carefully.
Chang
Jae Hyuck
JH
Department of Internal Medicine, The Catholic University of Korea College of Medicine, Seoul, Korea.
Kim
Sang Woo
SW
Chung
Woo Chul
WC
Kim
Young Chul
YC
Jung
Chan Kwon
CK
Paik
Chang Nyol
CN
Park
Jae Myung
JM
Cho
Yu Kyung
YK
Lee
In Seok
IS
Choi
Myung Gyu
MG
Chung
In Sik
IS
D000328:Adult; D000368:Aged; D002276:Carcinoid Tumor / Q000209:etiology / Q000473:pathology*; D018450:Disease Progression; D005260:Female; D005770:Gastrointestinal Neoplasms / Q000209:etiology / Q000473:pathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009362:Neoplasm Metastasis; D011237:Predictive Value of Tests; D012189:Retrospective Studies