Gastrointestinal carcinoid tumors: Long-term prognosis for surgically treated patients

To evaluate long-term survival of patients with gastrointestinal carcinoid tumors and to assess factors that may influence prognosis, 154 patients (49 % females, 51% males), median age 62 years (range 12-84 years) treated at o ur institution during 1972-1982 have been followed long term. Tumor locatio n included the foregut (7%), midgut (62%), and hindgut (30%). Ninety-five p ercent of the patients underwent surgical or endoscopic excision of the pri mary tumor, with overall operative mortality and postoperative morbidity ra tes of 2.6% and 11%, respectively. At follow-up, 60 patients (39%) were ali ve (median follow-up 18 years; range 1-26 years). The main causes of death included carcinoid tumor burden (32%), unrelated causes (45%), other malign ancy (19%), and unknown causes (4%). Observed overall 5- and 10-year surviv als were 69% and 53%, respectively. Survival was not related to gender or s ymptoms at presentation. However, age, embryologic origin, tumor size, dept h of invasion, nodal status, and stage of disease proved to be of statistic al significance (log-rank). In a multivariate Cox' model, only older age (> 62 years) [P = 0.001, odds ratio (OR) = 3.4) and embryologic origin (midgu t versus foregut) (P = 0.045, OR = 0.45) provided independent prognostic po wer when death from any cause was taken as the end-point. This study confir ms that patient's age and the site of the primary tumor have prognostic sig nificance. Carcinoid tumors are neuroendocrine tumors with a relatively goo d prognosis, and long-term survival is possible despite advanced stages of disease.