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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 - p 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.