Surgery as primary treatment in patients with liver metastases from carcinoid tumors: A retrospective, unicentric study over 13 years

Background. The heterogeneous nature of carcinoid tumors makes it difficult to develop a standardized treatment strategy for the primary tumor itself and for probable liver metastases. However, prolongation of the 5-year surv ival rate (5-ysr) and amelioration of the incapacitation symptoms after res ection of the primary tumor and its metastases demonstrate that surgical in tervention must be the treatment of choice in these tumors. Methods. The data of 31 patients (17 patients with midgut carcinoids, 10 pa tients with an endocrine carcinoma (carcinoid) of the pancreas, and 4 patie nts with carcinoids of the lung) who underwent liver operation for metastat ic carcinoid tumors between 1983 and 1996 were analyzed, with special regar d to factors influencing postoperative survival. Results. Ten patients underwent curative resection (5-ysr, 86%), and pallia tive operations were performed in 21 patients (5-ysr, 26%). The overall 5-y sr, 86%), and palliative operations were performed in 21 patients (5-ysr, 2 6%). The overall 5-ysr was 47%, with a mean postoperative follow-up of 3.5 years (range, 4 months to 10.8 years). Postoperative morbidity rate was 13% . Size of liver metastases, radicality of the operation and localization of the primary tumor were factors influencing postoperative survival. Conclusions. Surgery for metastatic carcinoid tumors may be curative or pal liative, with a potential for cure in some cases and prolongation of surviv al and amelioration of symptom sin the majority of patients.