Prognostic Factors for Colorectal Carcinoids

Abstract

Purpose. To investigate the treatment outcome of colorectal carcinoids in an institution over an 18-year time period.Materials and Methods. We performed a retrospective chart review of all the carcinoid tumors originating from the colon and rectum from January 1992 to December 2009. A total of 27 patients were included in the study. The patient's age, gender, tumor size, tumor location, disease stage, and management methods were recorded. All patients were treated using R0 tumor resection either by radical operation, wide local excision, or endoscopic excision. Disease-free and overall survival rates were compared on the basis of the tumor size, clinical stage, tumor location, and resection methods.Results. The five-year overall and disease-free survival rates were 88.9% and 80.9%, respectively. For tumors larger than 10 mm or of colonic origin, there was a significant increase in the incidence of lymph node or distant metastasis (p=0.0006 and p=0.03, respectively). Patients with a tumor size ≤ 10 mm had better 5-year disease-free and overall survival rate (p=0.001 and p=0.009, respectively), as did patients with rectal carcinoids (p=0.006 and p＜0.001, respectively). Patients at an early stage, according to American Joint Committee on Cancer (AJCC) staging system (stage I and II), had a better 5-year disease-free and overall survival rates compared with those at an advanced stage (stage III and IV) (p＜0.0001). For patients who underwent R0 resection with an adequate safety margin, neither surgery nor endoscopy could influence the 5-year disease-free or overall survival (p＞0.05).Conclusions. The incidence of rectal carcinoids is much higher in this series than that of the colonic carcinoids. Compared with colonic carcinoids, rectal carcinoids tend to be smaller and rarely metastasize. Patients with a tumor size ≥ 10 mm have a significantly higher incidence of metastasis and poorer disease-free and overall survival rates. Endoscopic resection or wide local excision is adequate to treat small-sized carcinoids.