Metastatic carcinoid tumor: changing patterns of care over two decades

Riferimento: 
J Clin Gastroenterol. 2010 Mar;44(3):195-9.
Autori: 
Townsend A, Price T, Yeend S, Pittman K, Patterson K, Luke C.
Fonte: 
J Clin Gastroenterol. 2010 Mar;44(3):195-9.
Anno: 
2010
Azione: 
Trattamento per i tumori carcinoidi metastatici (MCT) con analoghi della somatostatina long-acting può influire sul controllo della malattia e la sopravvivenza.
Target: 
Analoghi della somatostatina long-acting/tumori carcinoidi metastatici.

ABSTRACT
BACKGROUND:
Metastatic carcinoid tumors (MCTs), an important subgroup of neuroendocrine tumors, occur infrequently and often have an indolent course, limiting data on long-term treatment outcomes. We aimed to assess treatment trends at a single center over time and the impact on the outcome.
STUDY:
Patients diagnosed with carcinoid tumors in the North West Adelaide Health Service between January 1, 1985 and March 1, 2007 were identified from the South Australian Cancer Registry.
RESULTS:
We identified 92 patients with carcinoid tumors; 49 had MCT. Although treatment options increased over time, the most significant change was to access octreotide therapy, with 24 receiving long-acting somatostatin analogs. Survival improved over time and the median overall survival for patients receiving long-acting somatostatin analogs was 112 months compared with 53 months for those who did not (P=0.021, hazard ratio: 2.46). Ten year survival was 40% and 22%, respectively. About 75% of evaluable patients had a biochemical response to initial therapy and a measurable response occurred in 3 of 24 (13%) patients.
CONCLUSIONS:
This single center experience has provided insight into current treatment options for MCT, and suggests the use of long-acting somatostatin analogs may impact on disease control and survival. However, the uptake of other treatment options seems limited and there is a need for agents that target tumor progression.