The Southwestern Surgical CongressA proposed staging system for small bowel carcinoid tumors based on an analysis of 6,380 patients
Section snippets
Methods
The patient population for this study was obtained from the National Cancer Institute's Surveillance, Epidemiology and End Results (SEER) database. A search of the SEER database identified 15,983 patients with gastrointestinal carcinoid tumors (stomach, small bowel, colon, rectum, appendix) between 1977 and 2004. From these patients, 6,380 had carcinoid tumors of the small bowel. Patients diagnosed with tumors within a Meckel's diverticulum were included. Patients with cause of death in the
Patient demographics
Clinicopathologic characteristics of the patient population are displayed in Table 1. Of the 6,380 patients in the database, 47% were female and 53% were male. The median age at diagnosis was 66 years (range 14–98 years). Small intestinal carcinoid was the only primary malignancy in 68% of patients; 28% presented with 1 additional primary malignancy, and 4.2% had 2 or more additional malignancies. The mean and median sizes of primary tumor were 1.93 cm and 1.5 cm, respectively (range .1–30 cm).
Comments
Carcinoid tumor is a challenging disease to treat, and the lack of a staging system limits the clinician's ability to provide meaningful prognostic information to the patient. In the past, gastrointestinal carcinoid tumors have been divided into 3 groups according to embryologic origin: foregut (esophagus, stomach, pancreas, and duodenum), midgut (tumors from small mesenteric artery (SMA) distribution including ileum, appendix), and hind-gut (tumors from inferior mesenteric artery (IMA)
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