Small bowel carcinoids
What is the prognosis for small intestinal neuroendocrine tumors?
There has been little change in the prognosis of small intestinal neuroendocrine tumors over the past 30 years. The overall five year survival for small intestinal neuroendocrine tumors varies from 52-77%. Larger tumors, lymph node metastases, liver metastases, carcinoid syndrome, plasma chromogranin A levels > 5000 mg/ml and certain histologic features are associated with a worse prognosis. Histologic features that are predictive of reduced survival include an increased depth of invasion, vascular or lymphatic invasion, cellular atypia, necrosis, increased mitotic index, and an increase Ki-67 proliferative index. The five year survival rate is approximately 75% in patients with localized disease, 59-72% in patients with spread to regional lymph node metastases and 20-43% in patients with distant metastases. Although patients with liver metastases and carcinoid syndrome have a worse prognosis than those who have liver metastasis alone, the median survival is still 5-8 years.