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Metastatic Carcinoid Tumor: Changing Patterns of Care Over Two Decades

Townsend, Amanda MBBS, FRACP*; Price, Tim MBBS, FRACP; Yeend, Sue*; Pittman, Ken MBBS, FRACP*; Patterson, Kevin MBBS, FRACP*; Luke, Colin MBBS

Journal of Clinical Gastroenterology: March 2010 - Volume 44 - Issue 3 - pp 195-199
doi: 10.1097/MCG.0b013e3181a9f10a
ALIMENTARY TRACT: Original Articles

Background: Metastatic carcinoid tumors (MCTs), an important subgroup of neuroendocrine tumors, occur infrequently and often have an indolent course, limiting data on long-term treatment outcomes. We aimed to assess treatment trends at a single center over time and the impact on the outcome.

Study: Patients diagnosed with carcinoid tumors in the North West Adelaide Health Service between January 1, 1985 and March 1, 2007 were identified from the South Australian Cancer Registry.

Results: We identified 92 patients with carcinoid tumors; 49 had MCT. Although treatment options increased over time, the most significant change was to access octreotide therapy, with 24 receiving long-acting somatostatin analogs. Survival improved over time and the median overall survival for patients receiving long-acting somatostatin analogs was 112 months compared with 53 months for those who did not (P=0.021, hazard ratio: 2.46). Ten year survival was 40% and 22%, respectively. About 75% of evaluable patients had a biochemical response to initial therapy and a measurable response occurred in 3 of 24 (13%) patients.

Conclusions: This single center experience has provided insight into current treatment options for MCT, and suggests the use of long-acting somatostatin analogs may impact on disease control and survival. However, the uptake of other treatment options seems limited and there is a need for agents that target tumor progression.

*Department of Medical Oncology, The Queen Elizabeth Hospital

Department of Medical Oncology, The Queen Elizabeth Hospital and University of Adelaide

Department of Health, Epidemiology Branch, Adelaide, SA, Australia

Funding: There was no funding for this project.

Reprints: Amanda Townsend, MBBS, FRACP, Department of Medical Oncology, The Queen Elizabeth Hospital, 28 Woodville Road, Woodville, SA 5011, Australia (e-mail: Amanda.townsend@health.sa.gov.au).

Received for publication January 23, 2009

accepted April 10, 2009

Conflict of Interest: There are no conflicts of interest to declare.

© 2010 Lippincott Williams & Wilkins, Inc.