Abstracts
2002 Digestive Disease Week

# 101908 Abstract ID: 101908 Gastrointestinal Carcinoid Tumors: Biology Is Dependent upon Origin
Jamie J Van Gompel, Thomas F Warner, Herbert Chen, Madison, WI

BACKGROUND. Gastrointestinal (GI) carcinoids are neuroendocrine tumors that originate in multiple locations throughout the GI tract. The prognosis of patients with GI carcinoid tumors is quite diverse. In order to determine if the site of origin significantly affects prognosis, we reviewed our experience. METHODS. Between 1992 and 2000, 69 patients with GI carcinoid tumors underwent surgical resection at our institution. Patients were then grouped into 3 categories based upon the origin of the carcinoid tumor: foregut (stomach, pancreas, duodenum), midgut (jejunum, ileum, appendix, cecum), and hindgut (colon, rectum). RESULTS. The mean age of the 69 patients was 56 ?2 years and 58% were male. All 14 patients with foregut carcinoids had symptoms upon presentation (flushing, pain, diarrhea, bleeding) whereas 61% of midgut and only 37% of hindgut carcinoid patients had symptoms. (p<0.001). Patients with foregut tumors had larger tumors and more commonly had liver metastases at presentation. The factor that most strongly impacted survival on univariate analysis was origin. Patients with foregut or midgut lesion had significantly lower 5-year survivals then those with hindgut tumors. Moreover, the size of the primary tumor and the presence of liver metastases were not independent predictors of survival. CONCLUSIONS. The presentation and prognosis of patients with GI carcinoid tumors appear to differ between foregut, midgut, and hindgut tumors. Those patients with hindgut carcinoid tumors have the longest survival. Despite the larger tumor size and the higher incidence of liver metastases, patients with foregut carcinoids appear to have the same prognosis as those with midgut carcinoids. Therefore, these data suggest that the biology of carcinoid tumors is highly dependent upon origin.