Carcinoid Heart Disease: an Update

Quaedvlieg, Pascal; Lamers, C. B. H. W.; Taal, Babs G.

doi:10.1080/003655202320621481

Cited by 17 publications

(7 citation statements)

References 38 publications

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“…By releasing serotonin and other vasoactive substances into the systemic circulation, carcinoid tumors can cause carcinoid syndrome, characterized by diarrhea, flushing, wheezing and eventually right-sided valvular heart disease [4]. The occurrence and severity of the syndrome depend on the site of origin of the tumor and tumor mass, but the presence of carcinoid syndrome almost always implies distant metastases in the liver.…”

Section: Introductionmentioning

confidence: 99%

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Rapid and Sustained Relief from the Symptoms of Carcinoid Syndrome: Results from an Open 6-Month Study of the 28-Day Prolonged-Release Formulation of Lanreotide

Ruszniewski

Ish‐Shalom

Wymenga³

et al. 2004

Neuroendocrinology

146

102

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This 6-month, open, non-controlled, multicenter, dose-titration study evaluated the efficacy and safety of 28-day prolonged-release (PR) lanreotide in the treatment of carcinoid syndrome. Eligible patients had a carcinoid tumor with ≧3 stools/day and/or ≧1 moderate/severe flushing episodes/day. Six treatments of 28-day PR lanreotide were administered by deep subcutaneous injection. The dose for the first two injections was 90 mg. Subsequent doses could be titrated (60, 90, 120 mg) according to symptom response. Seventy-one patients were treated. Flushing decreased from a mean of 3.0 at baseline to 2.3 on day 1, and 2.0 on day 2, with a daily mean of 2.1 for the first week post-treatment (p < 0.05). Diarrhea decreased from a mean of 5.0 at baseline to 4.3 on day 1 (p < 0.05), and 4.5 on day 2, with a daily mean of 4.4 for the first week post-treatment (p < 0.001). Symptom frequency decreased further after the second and third injections, and reached a plateau after the fourth injection. By month 6, flushing and diarrhea had significantly decreased from baseline by a mean of 1.3 and 1.1 episodes/day, respectively (both p ≤ 0.001); 65% of patients with flushing as the target symptom and 18% of diarrhea-target patients achieved ≧50% reduction from baseline. Median urinary 5-hydroxyindoleacetic acid and chromogranin A levels decreased by 24 and 38%, respectively. Treatment was well tolerated. 28-day PR lanreotide was effective in reducing the symptoms and biochemical markers associated with carcinoid syndrome.

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Section: Introductionmentioning

confidence: 99%

“…The occurrence and severity of the syndrome depend on the site of origin of the tumor and tumor mass, but the presence of carcinoid syndrome almost always implies distant metastases in the liver. The syndrome is present in approximately 10% of patients with carcinoid tumors [4, 5]. …”

Section: Introductionmentioning

confidence: 99%

Rapid and Sustained Relief from the Symptoms of Carcinoid Syndrome: Results from an Open 6-Month Study of the 28-Day Prolonged-Release Formulation of Lanreotide

Ruszniewski

Ish‐Shalom

Wymenga³

et al. 2004

Neuroendocrinology

146

102

View full text Add to dashboard Cite

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“…Heart failure is one of the most serious manifestations of carcinoid syndrome, and it occurs in 20%-70% of patients with metastatic disease 40,42 . It is associated with a mortality rate as high as 50% of the mortality associated with these tumours, right ventricular failure being a major cause of death 33,84 .…”

Section: Carcinoid Heart Diseasementioning

confidence: 99%

Consensus Recommendations for the Diagnosis and Management of Well-Differentiated Gastroenterohepatic Neuroendocrine Tumours: A Revised Statement from a Canadian National Expert Group

et al. 2010

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Well-differentiated neuroendocrine tumours (netspreviously called "carcinoid tumours") are relatively rare tumours originating from the diffuse neuroendocrine system; they are found most often in the bronchial or gastrointestinal systems. In Canada, gastroenterohepatic nets represent less than 0.25% of oncology cases. Because of the relative rarity of these tumours, diagnostic and therapeutic approaches vary and are often based on individual physician experience. A number of European and North American groups have developed consensus guidelines for the diagnosis and management of well-differentiated gastroenterohepatic nets, and in 2006, Canadian consensus guidelines were published by a Canadian expert group. The updated and expanded current Canadian guidelines are based on a consensus meeting held in Paris, France, in 2008 and are based on the most current literature.

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“…. Resection of mesenterial fibrosis and heart valve replacement in patients with carcinoid syndrome and carcinoid heart disease (Ahlman 1996, Westberg et al 2001, Quaedvlieg et al 2002, Moller et al 2003.…”

Section: Correction Of Tumour-related Deficiencies or Disordersmentioning

confidence: 99%

“…In close collaboration with cardiologists and thoracic surgeons, protocols have been developed that include extensive cardiologic monitoring of patients with the carcinoid syndrome, in whom surgical and/or medical therapy has reduced the effects of hormonal hypersecretion. This will eventually lead to a careful selection of patients and correct timing of valve replacement before end-stage heart failure develops (Connolly et al 1995, Westberg et al 2001, Quaedvlieg et al 2002, Moller et al 2003.…”

Section: Correction Of Tumour-related Deficiencies or Disordersmentioning

confidence: 99%

Considerations concerning a tailored, individualized therapeutic management of patients with (neuro)endocrine tumours of the gastrointestinal tract and pancreas.

Herder

Krenning²,

Eijck³

et al. 2004

Endocr Relat Cancer

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Endocrine tumours of the gastrointestinal tract and pancreas may present at different disease stages with either hormonal or hormone-related symptoms/syndromes, or without hormonal symptoms. They may occur either sporadically or as part of hereditary syndromes. In the therapeutic approach to a patient with these tumours, excessive hormonal secretion and/or its effects should always be controlled first. Tumour-related deficiencies or disorders should also be corrected. Subsequently, control should be aimed at the tumour growth. Surgery is generally considered as first-line therapy for patients with localized disease, as it can be curative. However, in patients with metastatic disease the role of first-line surgery is not clearly established and other therapies should be considered, such as non-surgical cytoreductive therapies, biotherapy (with somatostatin analogues or interferon-a), embolization and chemoembolization of liver metastases, chemotherapy (with single or multiple dose regimens) and peptide receptor-targeted radiotherapy. The delicate balance of the use of the different therapeutical options in patients with endocrine tumours of the gastrointestinal tract and pancreas emphasizes the importance of team approach and team expertise.

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Carcinoid Heart Disease: an Update

Cited by 17 publications

References 38 publications

Rapid and Sustained Relief from the Symptoms of Carcinoid Syndrome: Results from an Open 6-Month Study of the 28-Day Prolonged-Release Formulation of Lanreotide

Rapid and Sustained Relief from the Symptoms of Carcinoid Syndrome: Results from an Open 6-Month Study of the 28-Day Prolonged-Release Formulation of Lanreotide

Consensus Recommendations for the Diagnosis and Management of Well-Differentiated Gastroenterohepatic Neuroendocrine Tumours: A Revised Statement from a Canadian National Expert Group

Considerations concerning a tailored, individualized therapeutic management of patients with (neuro)endocrine tumours of the gastrointestinal tract and pancreas.

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