Skip to content
My WebMD Sign In, Sign Up

Cancer Health Center

Font Size

Gastrointestinal Carcinoid Tumors Treatment (PDQ®): Treatment - Health Professional Information [NCI] - Appendiceal Carcinoids

Approximately 90% of appendiceal carcinoids measure smaller than 1 cm and are not located in the appendiceal base; these tumors can be consistently cured by appendectomy.[1]

Appendiceal carcinoids larger than 2 cm require right-sided hemicolectomy and ileocecal lymphadenectomy because of the significant risk of metastasis.[1] For tumors measuring 1 to 2 cm, treatment is controversial, but hemicolectomy may be appropriate if there is invasion in the mesoappendix, if there is residual tumor in the resection margins, or in the presence of lymph node metastases. For same-size lesions confined to the appendiceal wall, appendectomy alone may carry a low risk for metastases. Acceptable indications for hemicolectomy may include operative specimens that show high proliferative activity (high Ki67 index), high mitotic index, or signs of angioinvasion, but evidence is limited and histologic parameters for risk evaluation in appendiceal carcinoids measuring 1 cm to 2 cm requires definition.[1,2,3] Follow-up should be considered in patients for whom elevated serum chromogranin A may indicate the need for extended operation. Although survival is excellent with locoregional tumor, 10-year survival is approximately 30% with distant metastases.[1]

Recommended Related to Cancer

Treatment of Hepatocellular Carcinoma

Treatment Options for Stages I and II Complete surgical resection of primary tumor followed by chemotherapy.In a randomized trial, seven of eight patients with stage I hepatocellular carcinoma survived disease free after adjuvant cisplatin-based chemotherapy.[1] In a survey of childhood liver tumors treated prior to the consistent use of chemotherapy, only 12 of 33 patients with hepatocellular carcinoma who had complete excision of the tumor survived.[2] This suggests that adjuvant chemotherapy...

Read the Treatment of Hepatocellular Carcinoma article > >

Goblet cell carcinoid or adenocarcinoid is a rare variant of appendiceal carcinoid with mixed endocrine and exocrine features.[1] Often presenting with a diffusely inflamed appendix and occurring in patients at a later age (approximately 50 years), these tumors are aggressive, often with peritoneal and ovarian metastases, and occasionally appearing as mucinous adenocarcinoma.[2,3,4] They do not express somatostatin receptors and cannot be visualized by 111-Indium octreotide scintigraphy. Goblet cell carcinoids are treated with right-sided hemicolectomy and lymphadenectomy in combination with chemotherapy. For disseminated tumors, aggressive surgical reduction including peritonectomy and oophorectomy may be required.[1] Goblet cell carcinoids have a 10-year survival rate of approximately 60%.[2]

Current Clinical Trials

Check for U.S. clinical trials from NCI's list of cancer clinical trials that are now accepting patients with localized gastrointestinal carcinoid tumor and regional gastrointestinal carcinoid tumor. The list of clinical trials can be further narrowed by location, drug, intervention, and other criteria.

General information about clinical trials is also available from the NCI Web site.

References:

  1. Akerström G, Hellman P: Surgery on neuroendocrine tumours. Best Pract Res Clin Endocrinol Metab 21 (1): 87-109, 2007.
  2. Goede AC, Caplin ME, Winslet MC: Carcinoid tumour of the appendix. Br J Surg 90 (11): 1317-22, 2003.
  3. Stinner B, Rothmund M: Neuroendocrine tumours (carcinoids) of the appendix. Best Pract Res Clin Gastroenterol 19 (5): 729-38, 2005.
  4. Akerström G, Hellman P, Hessman O: Gastrointestinal carcinoids. In: Lennard TWJ, ed.: Endocrine Surgery. 4th ed. Philadelphia, Pa: WB Saunders Ltd, 2009, pp 147-76.
1

WebMD Public Information from the National Cancer Institute

Last Updated: February 25, 2014
This information is not intended to replace the advice of a doctor. Healthwise disclaims any liability for the decisions you make based on this information.
Next Article:

Today on WebMD

Building a Support System
Blog
cancer fighting foods
SLIDESHOW
 
precancerous lesions slideshow
SLIDESHOW
quit smoking tips
SLIDESHOW
 
Jennifer Goodman Linn self-portrait
Blog
what is your cancer risk
HEALTH CHECK
 
colorectal cancer treatment advances
Video
breast cancer overview slideshow
SLIDESHOW
 
prostate cancer overview
SLIDESHOW
lung cancer overview slideshow
SLIDESHOW
 
ovarian cancer overview slideshow
SLIDESHOW
Actor Michael Douglas
Article