Endoscopic treatment of gastrointestinal carcinoid tumors

Park, Yong Bum; Kim, Jin Il; Ha, Byung Hwa; Cheung, Dae Young; Kim, Tae Ho; Kim, Chang Hwan; Kim, Sung Soo; Cho, Se Hyun; Park, Soo Heon; Chae, Hiun Suk; Kim, Jae Kwang; Han, Sok Won

Abstract

BACKGROUND: The treatment of choice of gastrointestinal carcinoid tumors has been thought to be radical excision. However, surgical treatment has been substituted by endoscopic treatment in cases of small gastrointestinal carcinoid tumors. We evaluated the effectiveness of endoscopic treatment for gastrointestinal carcinoid tumors.
METHODS
We reviewed the medical records and endoscopic findings of 50 cases of gastrointestinal carcinoid tumors diagnosed in St. Mary's Hospital, Holy Family Hospital, and Uijeongbu St. Mary's Hospital, all affiliated organizations of the Catholic University Medical Center of Korea, from January 2001 to December 2006.
RESULTS
The mean age of the patients was 52.6+/-13.6 years-old. The mean tumor size was 10.1+/-5.6 mm. Thirty-eight cases were treated by endoscopy (mean tumor size: 8.6+/-4.5 mm), eleven cases were treated by surgery (mean tumor size: 13.5+/-6.1 mm), and one case with multiple metastases was untreatable by either endoscopy or surgery. Twenty five cases of endoscopic therapy were treated by endoscopic mucosal resection or endoscopic submucosal dissection. Thirteen cases were resected by use of a conventional polypectomy. Two cases of the conventional polypectomy were resected incompletely, and were treated with an additional endoscopy. No cases of endoscopic treatment have recurred during the follow-up period.
CONCLUSIONS
Recently, the incidence of carcinoid tumors is on the increase in the gastrointestinal tract, as determined by performing frequent endoscopic examinations in Korea. If the gastrointestinal carcinoid tumor is limited to the submucosal layer, endoscopic treatment could be sufficient as the primary treatment in selected patients with a tumor diameter of 10 mm or less in the duodenum and 15 mm or less in the stomach and rectum.