Implicancias anestésicas de los tumores neuroendocrinos y el síndrome carcinoide

Abstract

Neuroendocrine tumors (NETs) are a diverse group of neoplasms often linked to paraneoplastic syndromes such as carcinoid syndrome (CS) and carcinoid crisis (CC). Despite available treatments like somatostatin analogs, CC remains a critical and potentially fatal event, the management and etiology of which are still subjects of debate. The lack of a standardized definition for CC leads to discrepancies in the literature concerning both its reported incidence rates (3-50%) and the effectiveness of prophylactic treatment with octreotide. Sudden fluctuations in blood pressure are often the primary indicator of CC, and current clinical guidelines lack a consensus on treatment. To address these challenges in NET patients, the Anesthesiology team at the National Cancer Institute has developed a perioperative protocol. Created in collaboration with multidisciplinary specialists, this protocol aims to standardize pre-surgical evaluation to predict the risk of CC and the potential benefits of pharmacological prophylaxis. This approach aspires to improve symptomatic management and prepares the surgical team for contingencies, thereby contributing to more precise and safer care.