Carcinoid Tumor Follow-up

Updated: Feb 12, 2019
  • Author: Cameron K Tebbi, MD; Chief Editor: Max J Coppes, MD, PhD, MBA  more...
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The most serious complications of carcinoid tumors are carcinoid syndrome /crisis and metastasis, which is often observed in patients who have foregut tumors and high levels of 5-HIAA. [17]



The prognosis for patients with completely resected localized disease is excellent. [121, 122, 123, 124]  Tumors larger than 2 cm, positive lymph nodes, and atypical histologic features are often associated with a poor prognosis. [125] In patients with carcinoid tumors located in the appendix, age, primary tumor size, histologic features, lymph node involvement, and distant metastasis are significant factors in predicting survival. [126]  In one retroactive study, survival of patients with sigmoid colon was only 33% while 99% of those with appendiceal tumor had survived. [122] Second primary malignancies of gastrointestinal tract which occurred in up to 33% of cases in adults,are unusual in children and adolescents. [123]

In adult patients, factors associated with poor survival include persistence of plasma neurokinin A (NKA), urinary 50-hydroxyindolacetic acid output, age, and 5 or more liver metastases. Rise in plasma NKA appears to be independent of other prognostic factors and constitutes the strongest indication. [127]

Overall, localized carcinoid tumor which is completely resected has an excellent prognosis, the outcome for patients with metastasis, however, remains poor.