Surgical and adjuvant treatment of neuroendocrine tumors of the gastrointestinal tract and their metastases. A retrospective analysis of our own patients

Introduction: Carcinoid tumors are the most common neuroendocrine tumors of the gastrointestinal tract. Surgical treatment and prognosis depend on the location of the tumor. Method: Between 01.01.1985 and 31.12.1999 25 patien ts with neuroendocrine tumors of the gastrointestinal tract or their metast ases were treated in our institution. The records of these patients were re viewed retrospectively. Patients still alive were reexamined clinically. Re sults and conclusions: The most frequent primary sites were the ileum and j ejunum (36 %), appendix (36 %), stomach (12 %), pancreas (8 %), colon (4%) and bronchus with hepatic metastasis (4 %). A malignant carcinoid syndrome was present in 8 patients. In patients with neuroendocrine tumors, curative , radical tumor removal should be attempted. Some patients with advanced di sease needed some surgery for tumor debulking and resection of metastases. In non-resectable liver metastases hepatic arterial chemotherapy and chemoe mbolization after implantation of port catheters seem to be very beneficial therapeutic options. A, fixed part of the therapeutic regime in progressiv e disease is adjuvant chemotherapy with 5-fluorouracil and streptozotocin a nd symptomatic therapy with octreotide.