In north-east England, NET-MDT service started in 1999 and is ba

In north-east England, NET-MDT service started in 1999 and is based at Freeman Hospital, Newcastle upon

Tyne which is the regional tertiary centre. However, the utilisation of this service by the clinicians in peripheral hospitals in the region started much latter. In the current study GICT patients were referred to the regional NET MDT from 2006 onwards and in that period only 10 out of 18 patients (56%) with GICTs were referred to this MDT; details of radiology, surgery and histology were reviewed and further #phosphatase inhibitor library keyword# management and follow up plans made. Prognosis and follow up Prognosis of patients with GICTs is largely Inhibitors,research,lifescience,medical determined by age, race and sex of patients, site and size of the primary lesion, stage of the disease, histologic grade and extent of the disease (6). The incidence of nodal and distant metastasis is rare if the primary tumour size is less than 1 cm, however this increases significantly once the primary lesion is over 2 cm in size (58). As described above, patients with carcinoid tumours

Inhibitors,research,lifescience,medical in appendix and rectum carry a better prognosis with a five year survival ranging from 62-100% depending on the size of the primary lesion. Patients with small intestinal and colonic carcinoids carry a poorer prognosis with a five year survival ranging from 33-75%. Inhibitors,research,lifescience,medical Large patient series from Sweden (1960-2000) and from USA (1973-1999) have reported an age adjusted 5-year survival rates of 67% for midgut carcinoids (4,59). In a series of over 300 patients median survival was 12.4

years and 5-year survival was 91% in the absence of liver metastasis and 50% in patients with inoperable liver Inhibitors,research,lifescience,medical metastases (51). Significant symptom relief and long disease free survival have been consistently been reported following liver surgery in patients with carcinoid syndrome (2,10,45). Five year survival of over 70% has been reported following radical TCL curative liver resection but nearly all will eventually develop new metastases, often with slow progression. In fact, long term follow-up studies have identified the presence of liver metastases and carcinoid heart disease as the two most significant adverse prognostic indicators (51,59). The current study is a small series of abdominal carcinoid tumours treated at a single institution but it does represent a modest experience of midgut carcinoids (n=21). Compared to larger published studies, the median follow up time was only 24 months with the longest follow up time being 8 years and this could be partly attributed to some patients being followed up in the regional tertiary centre following referral after initial treatment locally.

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