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{{Carcinoid syndrome}}
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==Overview==
==Overview==
Prognosis varies from individual to individual. It ranges from a 95% 5 year survival for localized disease to a 20% 5 year survival for those with liver metastases. The average survival time from the start of octreotide treatment has increased to about 12 years.
If left untreated, patients with [[Carcinoid Syndrome|carcinoid syndrome]] may progress to develop [[flushing]], [[diarrhea]], and [[Carcinoid|carcinoid heart disease]] ([[valvular heart disease]] and [[Cardiac arrythmia|cardiac dysrythmias]]). Common [[complications]] of [[carcinoid tumor]] include increased risk of [[falls]] and [[injury]] (from [[hypotension]]), [[obstruction|bowel obstruction]], [[gastrointestinal bleeding]], [[heart failure|right-sided heart failure]], and [[fibrosis]] of the [[Tricuspid valves|tricuspid valve]] and [[pulmonary valve]], and rarely the [[mitral valve]] in cases with left sided involvement. [[Prognosis]] is generally good and the 5-year [[Survival rates|survival rate]] of [[patients]] with [[Carcinoid Syndrome|carcinoid syndrome]] is approximately 69.7%.


==Natural History , Complications and Prognosis==
==Natural History==
===Complications===
*If left untreated, [[patients]] with [[Carcinoid Syndrome|carcinoid syndrome]] may progress to develop [[flushing]], [[diarrhea]], and [[Carcinoid disease|carcinoid]] [[Heart diseases|heart disease]] [[Valvular heart disease|(valvular heart disease]] and [[Cardiac arrythmia|cardiac dysrythmias]]):<ref>General Information About Gastrointestinal (GI) Carcinoid Tumors
* Increased risk of falls and injury (from [[hypotension]])
. National Cancer Institute. http://www.cancer.gov/types/gi-carcinoid-tumors/hp/gi-carcinoid-treatment-pdq#link/_49_toc Accessed on September 24, 2015</ref>
* Bowel [[obstruction]] (from tumor)
**[[Pathological|Pathologically]], the [[cardiac]] [[Valves of the heart|valves]] become thickened because of [[fibrosis]]
* [[Gastrointestinal bleeding]]
**[[Tricuspid]] and [[pulmonic valves]] are affected to a greater extent than the [[mitral]] and [[aortic valves]]
* Right-sided [[heart failure]]
*They have a very slow [[Growth|growth rate]] compared to most [[malignant tumors]]
===Prognosis===
 
The outlook in patients with carcinoid syndrome is different from the outlook in patients who have carcinoid tumors without the syndrome.
==Complications==
In people with the syndrome, the tumor has usually spread to the liver, which lowers the survival rate. People with carcinoid syndrome are also more likely to have a separate cancer (second primary tumor) at the same time.
Common [[complications]] of [[carcinoid tumor]] include:<ref>Carcinoid syndrome. U.S. National Library of Medicine. https://www.nlm.nih.gov/medlineplus/ency/article/000347.htm</ref>
The outlook is more favorable with new treatment methods, such as [[Sandostatin]].
*Increased risk of [[falls]] and [[injury]] (from [[hypotension]])
*[[Obstruction|Bowel obstruction]]
*[[Gastrointestinal bleeding]]
*[[Carcinoid Disease|Carcinoid heart disease]] develops in more than one-third of [[patients]] with [[Carcinoid Syndrome|carcinoid syndrome:]]<ref>General Information About Gastrointestinal (GI) Carcinoid Tumors
. National Cancer Institute. http://www.cancer.gov/types/gi-carcinoid-tumors/hp/gi-carcinoid-treatment-pdq#link/_49_toc Accessed on September 24, 2015</ref>
*[[Fibrosis]] of the [[Tricuspid valves|tricuspid valve]] and [[pulmonary valve]], rarely the [[mitral valve]] in cases with left sided involvement
::*[[Tricuspid]] and [[pulmonic regurgitation]] ("TIPS" - [[tricuspid insufficiency|Tricuspid Insufficiency]], [[pulmonary stenosis|Pulmonic Stenosis]])
::*[[Pulmonary stenosis]]
::*[[Mitral]] and [[aortic insufficiency]]
::*[[Cardiac arrhythmias|Cardiac dysrhythmias]]
 
==Prognosis==  
*Prognosis o[[Carcinoid tumors|f carcinoid tumor]] is generally good and the 5-yea[[Survival rates|r survival rate]] of [[patients]] is approximately:<ref name="pmid15213627">{{cite journal| author=Maggard MA, O'Connell JB, Ko CY| title=Updated population-based review of carcinoid tumors. | journal=Ann Surg | year= 2004 | volume= 240 | issue= 1 | pages= 117-22 | pmid=15213627 | doi= | pmc=PMC1356383 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15213627  }} </ref>
:*[[Stomach]]-75.1%
:*[[Intestine|Small Intestine]]-76.1%
:*[[Appendix]]-76.3%
:*[[Rectum]]-87.5%
*Factors that determine the prognosis of patients with [[gastrointestinal]] [[carcinoid tumors]] include:<ref>Carcinoid tumor. National cancer institute. http://www.cancer.gov/types/gi-carcinoid-tumors/hp/gi-carcinoid-treatment-pdq</ref>
:*Site of [[origin]]
:*Size of th[[Primary tumor|e primary tumor]]
:*[[Anatomical]] extent of [[disease]]
*Negative [[Prognostic|prognostic factors]] include:
**[[Carcinoid]] [[heart]] [[disease]]
**High [[concentrations]] of the [[tumor markers]] - [[urinary]] [[5-HIAA]] and [[Plasma (blood)|plasma]] [[chromogranin A]]
**[[Metastases|Metastasis]] to the [[liver]]
**[[Carcinoid tumor]] in the [[thymus]]
**Overexpression of the [[proliferation]] [[antigen]] Ki-67
**[[Mutations|Mutation]] in the ''[[p53]]'' [[gene]]


==References==
==References==
{{reflist|2}}
{{reflist|2}}


[[Category:Disease]]
[[Category:Gastroenterology]]
[[Category:Types of cancer]]
[[Category:Endocrinology]]
[[Category:Pulmonology]]
[[Category:Hematology]]


[[Category:Hematology]]
[[Category:Oncology]]
[[Category:Endocrinology]]
[[Category:Gastroenterology]]


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Latest revision as of 21:51, 21 April 2019

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Parminder Dhingra, M.D. [2]

Overview

If left untreated, patients with carcinoid syndrome may progress to develop flushing, diarrhea, and carcinoid heart disease (valvular heart disease and cardiac dysrythmias). Common complications of carcinoid tumor include increased risk of falls and injury (from hypotension), bowel obstruction, gastrointestinal bleeding, right-sided heart failure, and fibrosis of the tricuspid valve and pulmonary valve, and rarely the mitral valve in cases with left sided involvement. Prognosis is generally good and the 5-year survival rate of patients with carcinoid syndrome is approximately 69.7%.

Natural History

Complications

Common complications of carcinoid tumor include:[2]

Prognosis

References

  1. ↑ General Information About Gastrointestinal (GI) Carcinoid Tumors . National Cancer Institute. http://www.cancer.gov/types/gi-carcinoid-tumors/hp/gi-carcinoid-treatment-pdq#link/_49_toc Accessed on September 24, 2015
  2. ↑ Carcinoid syndrome. U.S. National Library of Medicine. https://www.nlm.nih.gov/medlineplus/ency/article/000347.htm
  3. ↑ General Information About Gastrointestinal (GI) Carcinoid Tumors . National Cancer Institute. http://www.cancer.gov/types/gi-carcinoid-tumors/hp/gi-carcinoid-treatment-pdq#link/_49_toc Accessed on September 24, 2015
  4. ↑ Maggard MA, O'Connell JB, Ko CY (2004). "Updated population-based review of carcinoid tumors". Ann Surg. 240 (1): 117–22. PMC 1356383. PMID 15213627.
  5. ↑ Carcinoid tumor. National cancer institute. http://www.cancer.gov/types/gi-carcinoid-tumors/hp/gi-carcinoid-treatment-pdq


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