Risk of Second Cancers in Patients with Colorectal Carcinoids

Tichansky, David S.; Cagir, Burt; Borrazzo, Edward C.; Topham, Allan; Palazzo, Juan; Weaver, Eric J.; Lange, Andrea; Fry, Robert D.

doi:10.1007/s10350-004-6119-y

Cited by 76 publications

(76 citation statements)

References 17 publications

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“…Non-endocrine neoplasms had been previously diagnosed in 70.0%% of the patients. Little information is available in the literature regarding the true incidence of second neoplasms in patients with NET (13)(14)(15). The association rate was 11.0% in our series, primarily with NET of the small bowel and pancreas (data not shown).…”

Section: Patient Populationmentioning

confidence: 59%

Observational study of patients with gastroenteropancreatic and bronchial neuroendocrine tumors in Argentina: Results from the large database of a multidisciplinary group clinical multicenter study

O’Connor

Marmissolle

Bestani³

et al. 2014

Molecular and Clinical Oncology

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Abstract. Neuroendocrine tumors (NET) include a spectrum of malignancies arising from neuroendocrine cells throughout the body. The objective of this clinical investigation of retrospectively and prospectively collected data was to describe the prevalence, demographic data, clinical symptoms and methods of diagnosis of NET and the treatment and long-term follow-up of patients with NET. Data were provided by the participating centers and assessed for consistency by internal reviewers. All the cases were centrally evaluated (when necessary) by the pathologists in our group. The tissue samples were reviewed by hematoxylin and eosin and immunohistochemical staining techniques to confirm the diagnosis of NET. In total, 532 cases were documented: 461 gastroenteropancreatic-NET (GEP-NET) and 71 bronchial NET (BNET). All the tumors were immunohistochemically defined according to the World Health Organization (WHO) and European Neuroendocrine Tumor Society criteria. The most common initial symptoms in GEP-NET were abdominal pain, diarrhea, bowel obstruction, flushing, gastrointestinal bleeding and weight loss. The most common tumor types were carcinoid (58.0%), non-functional pancreatic tumor (23.0%), metastatic NET of unknown primary (16.0%) and functional pancreatic tumor (3.0%). Of the BNET, 89.0% were typical and 11.0% atypical carcinoids. Of the patients with GEP-NET, 59.2% had distant metastasis at diagnosis. The locations of the primary tumors in GEP-NET were the small bowel (26.9%), pancreas (25.2%), colon-rectum (12.4%), appendix (7.6%), stomach (6.9%), esophagus (2.8%), duodenum (2.0%) and unknown primary (16.3%). The histological subtypes based on the WHO classification were well-differentiated NET (20.1%), well-differentiated neuroendocrine carcinomas (66.5%) and poorly differentiated neuroendocrine carcinomas (10.3%). Overall, 67.3% of the patients underwent surgery, 41.2% with curative intent and 26.1% for palliative purposes. The 5-year survival rates were 65.1% (95% confidence interval, 58.0-71.4%) in GEP-NET and 100.0% in typical carcinoid of the lung. This observational, non-interventional, longitudinal study aimed to accumulate relevant information regarding the epidemiology, clinical presentation and current practices in the treatment of NET patients in Argentina, providing insight into regional differences and patterns of care in this heterogeneous disease.

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Section: Patient Populationmentioning

confidence: 59%

Observational study of patients with gastroenteropancreatic and bronchial neuroendocrine tumors in Argentina: Results from the large database of a multidisciplinary group clinical multicenter study

O’Connor

Marmissolle

Bestani³

et al. 2014

Molecular and Clinical Oncology

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“…The increased risk of second cancer in patients with carcinoid may be related to a genetic predisposition to certain cancer, including neuroendocrine and nonneuroendocrine tumors [21]. In our series, six of 38 patients (15%) developed colorectal adenocarcinoma.…”

Section: Discussionmentioning

confidence: 61%

“…Patients treated for appendix carcinoid have an increased risk of second cancer [2,8,15,20,21], which was the case in 18% of our patients. The increased risk of second cancer in patients with carcinoid may be related to a genetic predisposition to certain cancer, including neuroendocrine and nonneuroendocrine tumors [21].…”

Section: Discussionmentioning

confidence: 65%

Laparoscopic versus open resection for appendix carcinoid

et al. 2006

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Background: Since an increasing number of appendectomies are performed via laparoscopy, it is crucial to determine the impact of this approach on appendix carcinoid (AC) outcome. The goal of this study was to compare results of laparoscopic (LAP) versus open (OP) appendectomy for AC according to intend to treat approach. Methods: A retrospective review (1991)(1992)(1993)(1994)(1995)(1996)(1997)(1998)(1999)(2000)(2001)(2002)(2003) identified 39 patients (median age, 36 years; range, 12-83) treated by laparoscopy (LAP) or laparotomy (OP) for AC in a single institution. Follow-up was complete for all patients (median, 67 months; range, 4-132). Results: Most cases had associated acute appendicitis (64%). Median carcinoid size was 1.1 cm (range, 0.3-5) and 0.4 cm (range, 0.2-3) in the LAP and OP groups, respectively. LAP and OP were performed in 21 (54%) and 18 (46%) patients, respectively. Surgical margins were positive in two patients in the LAP group and one patient in the OP group (p = 0.6). Right colectomies were performed for AC >2 cm in five patients after LAP and in four patients after OP (p = 0.9). Actuarial 5-year survival rates were 100 and 94% in the LAP and OP groups, respectively (p = 0.2). Two patients died in the OP group, one due to metastatic carcinoid and the other due to metachronous colorectal cancer. Synchronous or metachronous colorectal carcinomas developed in six patients (15%). Conclusion: Laparoscopic appendectomy is a safe procedure for AC, with carcinologic and long-term results similar to those of conventional appendectomy. Thus, pre-or per-operative suspicion of AC is not a contraindication to LAP. Prognosis of AC appears more dependent on carcinoid malignant potential or associated tumors. Risk for developing colorectal adenocarcinoma is high in AC patients and warrants follow-up of all patients with colonoscopic screening.

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“…Although NET generally has a better prognosis than adenocarcinomas at the same site, NET is incurable once they advance to unresectable metastatic disease [5]. At the same time, even if these patients are cured of NET, they still have a significant chance of developing a second cancer [6]. This second lesion could develop in sites not only in the rectum but also in all of the sites at risk including the lungs, prostate, and urinary system.…”

Section: Discussionmentioning

confidence: 99%

“…However, the recurrence and de novo malignancy would mostly be determined by the NET for the previous studies showing a high association of second primary malignancies with G1 NET [6]. Therefore, a vigilant followup and surveillance is necessary not only in the colon and rectum but also in all of the sites at risk.…”

Section: Discussionmentioning

confidence: 99%

Synchronous Collision Neuroendocrine Tumor and Rectal Adenocarcinoma: a Case Report

Zhu

Zhang

et al. 2015

Indian J Surg

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Collision tumors are thought to arise from the accidental meeting of two independent tumors. Adenocarcinoma is the most common malignant rectal tumor, while neuroendocrine tumor (NET) is relatively rare. Due to the endoscopy and reporting, the overall incidence of NETs was increasing recently but still less than 1 per 100,000. This means that a combination of an adenocarcinoma and NET is a very rare finding and an actual collision of these tumors even more so. We report here a highly unusual case of a 64-year-old woman who had collision tumors composed of a primary rectal adenocarcinoma and NET showing a "side by side" pattern. Resection margins are free of both the tumors. The postoperative course was uneventful. The patient underwent a protocol CT scan at 3 months after surgery, which did not show any recurrence. Both the malignant adenocarcinoma and the NET would make a great influence in the rest lifetime and a follow up will be continued, although the CT did not show any recurrence until now. To the best of our knowledge, this is the first reported case of such an occurrence.

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Risk of Second Cancers in Patients with Colorectal Carcinoids

Cited by 76 publications

References 17 publications

Observational study of patients with gastroenteropancreatic and bronchial neuroendocrine tumors in Argentina: Results from the large database of a multidisciplinary group clinical multicenter study

Observational study of patients with gastroenteropancreatic and bronchial neuroendocrine tumors in Argentina: Results from the large database of a multidisciplinary group clinical multicenter study

Laparoscopic versus open resection for appendix carcinoid

Synchronous Collision Neuroendocrine Tumor and Rectal Adenocarcinoma: a Case Report

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