Metastatic Carcinoid Tumors: A Clinical Review

Abstract Learning Objectives After completing this course, the reader will be able to: Describe the epidemiology of carcinoid tumors and the survival rates observed in patients with different stages of disease. Discuss the diagnostic modalities available for assessing carcinoid tumors and be able to use the results of these studies to choose a treatment option. Summarize the current therapeutic options for the treatment of carcinoid tumors. Identify the importance of carcinoid-related heart disease (CHD) on prognosis in patients with carcinoid tumors. Access and take the CME test online and receive 1 hour of AMA PRA category 1 credit at CME.TheOncologist.com Carcinoid tumors are neuroendocrine tumors derived from enterochromaffin cells, which are widely distributed in the body. They can originate from any location in the body, but they are traditionally described as originating from the foregut, midgut, and hindgut. Although the overall incidence of carcinoid tumors appears to have increased in the past decades, the prognosis for patients with metastatic carcinoid tumors has improved during the last decade. Due to longer survival times, complications, such as carcinoid heart disease, and new metastatic patterns, like skin and bone metastases, may become more important features of carcinoid disease. Therapy focused on these complications should be part of the management. Combining new diagnostic and treatment modalities in metastatic carcinoid patients may result in better quality of life and longer survival times. The increasing number of therapeutic options and diagnostic procedures requires a multidisciplinary approach, with decisions made in multidisciplinary meetings focused on “tailor-made” therapy based on patients' specific conditions. Because carcinoid tumors are uncommon, effort should be made to treat these patients in specialized centers and for these centers to join together in multicenter studies.