Recent trends in the treatment of well-differentiated endocrine carcinoma of the small bowel

作     者：Gilles Poncet Jean-Luc Faucheron Thomas Walter 

作者机构：Department of Digestive Surgery Edouard Herriot Hospital 69437 Lyon cedex 03 France Department of Colorectal Surgery Michallon Hospital 38043 Grenoble cedex France Department of Medical Oncology Pavillon H Edouard Herriot Hospital 69437 Lyon Cedex 03 France 

出 版 物：《World Journal of Gastroenterology》 (世界胃肠病学杂志（英文版）)

年 卷 期：2010年第16卷第14期

页      面：1696-1706页

核心收录：

学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学] 

主　　题：Gastrointestinal neoplasms Neuroendocrine carcinoma Carcinoid tumor Somatostatin analogs Therapeutic chemoembolization Surgery 

摘      要：Well-differentiated endocrine carcinomas of the small bowel are fairly rare neoplasms that present many clinical challenges. They secrete peptides and neuroamines that may cause carcinoid syndrome. However, many are clinically silent until late presentation with major effects. Initial treatment aims to control carcinoid syndrome with somatostatin analogs. Even if there is metastatic spread, surgical resection of the primitive tumor should be discussed in cases of retractile mesenteritis, small bowel ischemia or subocclusive syndrome in order to avoid any acute complication, in particular at the beginning of somatostatin analog treatment. The choice of treatment depends on the symptoms, general health of the patient, tumor burden, degree of uptake of radionuclide, histological features of the tumor, and tumor growth. Management strategies include surgery for cure (which is rarely achieved) or for cytoreduction, radiological interventions (transarterial embolization or radiofrequency ablation), and chemotherapy (interferon and somatostatin analogs). New biological agent and radionuclide targeted therapies are under investigation. Diffuse and non-evolving lesions should also be simplymonitored. Finally, it has to be emphasized that it is of the utmost importance to enroll these patients with a rare disease in prospective clinical trials assessing new therapeutic strategies.