title: Gastrointestinal carcinoids: an increasing incidence of rectal distribution.
abstract: Carcinoid tumors are slow-growing and usually become symptomatic late in the course of the disease. We evaluated our 10-year experience in the management of GI carcinoid tumors. The records of 133 patients with GI carcinoids were reviewed. The rectum was the most common site for carcinoid tumors with an incidence of 30 per cent followed by jejunoileal at 29.3 per cent. Other sites of carcinoid tumors were the appendix (8.3%), colon (8.3%), and duodenum (3.8%). Endoscopy was the most helpful modality in diagnosing GI carcinoids. CT was not helpful in preoperative diagnosis of carcinoid tumor. Fifteen patients died in follow-up with eight deaths related to carcinoid tumors, in the small bowel (6), rectum (1), and colon (1). Overall survival was 68.7 per cent and mortality rate was 19.5 per cent from carcinoid tumors. Most of the deaths occurred in patients with carcinoid syndrome, synchronous malignancy, and malignant carcinoid tumors. The mean disease-free survival was 51 months (range, 15 to 138 months). Screening colonoscopy, in addition to decreasing colorectal adenocarcinoma mortality, is useful in diagnosing carcinoid tumors at an earlier stage and in decreasing mortality from malignant colorectal carcinoid tumors.
authors.affiliation: Department of Surgery, Providence Hospital and Medical Centers, Southfield, Michigan 48075, USA. Paul.Avenel@providence-stjohnhealth.org
authors.forename: Paul
authors.initials: P
authors.lastname: Avenel
authors.forename: Alasdair
authors.initials: A
authors.lastname: McKendrick
authors.forename: Sumet
authors.initials: S
authors.lastname: Silapaswan
authors.forename: Ramachandra
authors.initials: R
authors.lastname: Kolachalam
authors.forename: William
authors.initials: W
authors.lastname: Kestenberg
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Ferguson
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Jacobs
authors.forename: Yousif
authors.initials: Y
authors.lastname: Goriel
authors.forename: Vijay
authors.initials: V
authors.lastname: Mittal
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002276:Carcinoid Tumor / Q000175:diagnosis / Q000453:epidemiology / Q000601:surgery*; D016009:Chi-Square Distribution; D003113:Colonoscopy; D016099:Endoscopy, Gastrointestinal; D005260:Female; D005500:Follow-Up Studies; D005770:Gastrointestinal Neoplasms / Q000175:diagnosis / Q000453:epidemiology / Q000601:surgery*; D006801:Humans; D015994:Incidence; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D012004:Rectal Neoplasms / Q000175:diagnosis / Q000453:epidemiology / Q000601:surgery*; D012042:Registries; D012189:Retrospective Studies; D015996:Survival Rate; D014057:Tomography, X-Ray Computed