Prediction of prognosis by echocardiography in patients with midgut carcinoid syndrome

Westberg, Gunnar; Wängberg, Bo; Ahlman, Håkan; Bergh, Claes‐Håkan; Beckman-Suurküla, M.; Caidahl, Kenneth

doi:10.1046/j.0007-1323.2001.01798.x

Cited by 106 publications

(100 citation statements)

References 28 publications

(21 reference statements)

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“…In metastatic NET with production of hormones the development of CHD is reported in 20 -70% of the patients (Tornebrandt et al, 1986;Robiolio et al, 1995;Westberg et al, 2001;Zuetenhorst et al, 2003) and in many patients attributed to the cause of death (Ross and Roberts, 1985). In the present series of 32 patients, the incidence of CHD is 28%, which is rather low compared to the results reported in literature.…”

Section: Discussioncontrasting

confidence: 39%

“…Carcinoid heart disease (CHD) is a well-known complication of long-lasting exposure to high levels of serotonin (Tornebrandt et al, 1986;Lundin et al, 1988;Robiolio et al, 1995;Westberg et al, 2001;Zuetenhorst et al, 2003). Many carcinoid patients die from cardiac causes (Ross and Roberts, 1985) and the detection of CHD in an early stage is important to adjust therapy and hence improve prognosis.…”

mentioning

confidence: 99%

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Role of natriuretic peptides in the diagnosis and treatment of patients with carcinoid heart disease

et al. 2004

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Carcinoid heart disease (CHD) occurs in 20 -70% of the patients with metastatic well-differentiated neuroendocrine tumours (NET). We evaluated whether natriuretic peptides (ANP or NT-proBNP) are useful in early detection of CHD. Blood samples from 32 patients with NET were compared with cardiac ultrasound follow-up. CHD was defined as thickening of the tricuspid valve in the presence of grade III -IV/IV tricuspid valve regurgitation. CHD was found in nine out of 32 patients (28%), all with symptoms of the carcinoid syndrome compared to 65% in the 23 patients without CHD (P ¼ 0.04). Median levels of NT-proBNP and 5-HIAA were significantly higher in patients with CHD (894 ng l À1 and 815 mmol 24 h À1 ) compared to those without (89 and 206 ng l À1 , Po0.001 and P ¼ 0.007). No significant differences were detected in ANP levels (P ¼ 0.11). Dilatation of the right atrium and ventricle as well as thickening of the tricuspid valve and degree of regurgitation were statistically significant correlated with NT-proBNP levels. The accuracy of NT-proBNP in the diagnosis of CHD was higher than that of ANP. A significantly better survival was observed in case of normal NT-proBNP values. In conclusion, NT-proBNP is helpful as a simple marker in the diagnosis of CHD. Survival is better in patients with normal levels of NT-proBNP.

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Section: Discussioncontrasting

confidence: 39%

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confidence: 99%

Role of natriuretic peptides in the diagnosis and treatment of patients with carcinoid heart disease

et al. 2004

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“…Samples from a total of 24 primary tumours and 28 liver metastases were obtained; in nine cases, both primary tumour and liver metastases were available from the same patient. We retrieved complete clinical data for all patients including age at diagnosis, sex, hormonal symptoms, carcinoid heart disease (defined as tricuspid regurgitation by echocardiography), surgery, somatostatin analogues, hepatic arterial embolization and survival (Westberg et al 2001). The histopathological evaluation was performed on haematoxylin-eosinstained sections.…”

Section: Tumour Materialsmentioning

confidence: 99%

High-resolution genomic profiling reveals gain of chromosome 14 as a predictor of poor outcome in ileal carcinoids

Andersson¹,

Swärd²,

Stenman³

et al. 2009

Endocrine-Related Cancer

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Ileal carcinoids are malignant neuroendocrine tumours of the small intestine. The aim of this study was to obtain a high-resolution genomic profile of ileal carcinoids in order to define genetic changes important for tumour initiation, progression and survival. Forty-three patients with ileal carcinoids were investigated by high-resolution array-based comparative genomic hybridization. The average number of copy number alterations (CNAs) per tumour was 7

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“…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%

“…. 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%

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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Prediction of prognosis by echocardiography in patients with midgut carcinoid syndrome

Cited by 106 publications

References 28 publications

Role of natriuretic peptides in the diagnosis and treatment of patients with carcinoid heart disease

Role of natriuretic peptides in the diagnosis and treatment of patients with carcinoid heart disease

High-resolution genomic profiling reveals gain of chromosome 14 as a predictor of poor outcome in ileal carcinoids

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

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