Duodenal Carcinoid Tumors: How Aggressive Should We Be?

Nicholas Zyromski, Michael L. Kendrick, David M. Nagorney, Clive S. Grant, John H. Donohue, Michael B. Farnell, Geoffrey B. Thompson, David R. Farley, Michael G. Sarr

Research output: Contribution to journalArticle

81 Citations (Scopus)

Abstract

Duodenal carcinoid tumors are uncommon. It is not known whether they behave more like carcinoid tumors in the appendix (indolent course) or those in the ileum (often virulent) - crucial information for determining the need for radical resection. A retrospective review at our tertiary referral center (from 1976 to 1999) identified 27 patients with primary duodenal carcinoid lesions, excluding functional islet cell tumors. Endoscopic biopsy provided the diagnosis in 78% of patients. Treatment was by endoscopic excision (n = 11), transduodenal excision (n = 8), pancreaticoduodenectomy (n = 3), segmental distal duodenectomy (n = 2), or palliative operation (n = 2). One patient did not undergo operation because of comorbidity. Eighteen of 19 patients with tumors smaller than 2 cm remained disease free after local (endoscopic or transduodenal) excision. The exception was a patient with a small periampullary carcinoid lesion. In contrast, all four patients with carcinoid tumors 2 cm or larger who were resected for cure developed a recurrence (2 to 9 years postoperatively). We conclude that duodenal carcinoid tumors smaller than 2 cm may be excised locally; to ensure complete resection we recommend open transduodenal excision for tumors between 1 and 2 cm. Endoscopic follow-up is indicated. It is unclear whether patients with larger tumors benefit from more aggressive locoregional resection. Ampullary/periampullary carcinoid tumors should be considered separately, as their behavior is unpredictable.

Original languageEnglish (US)
Pages (from-to)588-593
Number of pages6
JournalJournal of Gastrointestinal Surgery
Volume5
Issue number6
DOIs
StatePublished - Nov 2001
Externally publishedYes

Fingerprint

Carcinoid Tumor
Islet Cell Adenoma
Neoplasms
Pancreaticoduodenectomy
Appendix
Ileum
Tertiary Care Centers
Comorbidity
Biopsy
Recurrence

Keywords

  • Carcinoid tumor
  • Duodenum
  • Endoscopy
  • Neuroendocrine tumor

ASJC Scopus subject areas

  • Surgery

Cite this

Zyromski, N., Kendrick, M. L., Nagorney, D. M., Grant, C. S., Donohue, J. H., Farnell, M. B., ... Sarr, M. G. (2001). Duodenal Carcinoid Tumors: How Aggressive Should We Be? Journal of Gastrointestinal Surgery, 5(6), 588-593. https://doi.org/10.1016/S1091-255X(01)80100-1

Duodenal Carcinoid Tumors : How Aggressive Should We Be? / Zyromski, Nicholas; Kendrick, Michael L.; Nagorney, David M.; Grant, Clive S.; Donohue, John H.; Farnell, Michael B.; Thompson, Geoffrey B.; Farley, David R.; Sarr, Michael G.

In: Journal of Gastrointestinal Surgery, Vol. 5, No. 6, 11.2001, p. 588-593.

Research output: Contribution to journalArticle

Zyromski, N, Kendrick, ML, Nagorney, DM, Grant, CS, Donohue, JH, Farnell, MB, Thompson, GB, Farley, DR & Sarr, MG 2001, 'Duodenal Carcinoid Tumors: How Aggressive Should We Be?', Journal of Gastrointestinal Surgery, vol. 5, no. 6, pp. 588-593. https://doi.org/10.1016/S1091-255X(01)80100-1
Zyromski, Nicholas ; Kendrick, Michael L. ; Nagorney, David M. ; Grant, Clive S. ; Donohue, John H. ; Farnell, Michael B. ; Thompson, Geoffrey B. ; Farley, David R. ; Sarr, Michael G. / Duodenal Carcinoid Tumors : How Aggressive Should We Be?. In: Journal of Gastrointestinal Surgery. 2001 ; Vol. 5, No. 6. pp. 588-593.
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