| Theme |
Neuroendocrine Tumor of the Gastrointestinal Tract |
| Title |
Therapeutic Strategy for Patients with Colorectal Carcinoid Tumors |
| Author |
Hideki Ueno |
Department of Surgery, National Defense Medical College |
| Author |
Hidetaka Mochizuki |
Department of Surgery, National Defense Medical College |
| Author |
Yojiro Hashiguchi |
Department of Surgery, National Defense Medical College |
| Author |
Megumi Ishiguro |
Department of Surgery, National Defense Medical College |
| Author |
Masayoshi Miyoshi |
Department of Surgery, National Defense Medical College |
| Author |
Taichi Sato |
Department of Surgery, National Defense Medical College |
| [ Summary ] |
A therapeutic strategy for patients with colorectal carcinoid tumors was discussed. The depth of invasion, tumor size, gross appearance, and histological features, such as vascular invasion, were important parameters in determining the use of local excision [endoscopic mucosal resection (EMR) or surgical excision] or radical surgery with lymphadenectomy. Patients with carcinoid tumors invading into or through the MP layer, carcinoid tumors >20 mm in size, carcinoid tumors with depression or ulceration should undergo radical surgery with lymphadenectomy, even if no swollen lymph nodes are detected preoperatively. On the other hand, carcinoid tumors without the above adverse characteristics should be treated with local excision first, and additional laparotomy should be considered, based on histological examination of the resected specimens. In regard to carcinoid tumors 10 - 20 mm in size, in which the incidence of lymph node metastasis was reported to be 20 - 30 %, there is a belief that radical surgery should be considered, irrespective of other risk factors. After excision of carcinoid tumors, patients were followed up on according to the surveillance schedule for colorectal carcinoma. However, prospective multi-institutional studies are essential for establishing a standard surveillance program for patients with carcinoid tumors. |