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Midgut Carcinoid Tu...
Midgut Carcinoid Tumours : New Diagnostic Procedures and Treatment
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- Welin, Staffan, 1966- (author)
- Uppsala universitet,Institutionen för medicinska vetenskaper
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Janson, Eva T. (thesis advisor)
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Eriksson, Barbro (thesis advisor)
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- Kvols, Larry, Professor (opponent)
- Inter Disciplinary Oncology, Lee Moffitt Cancer Center&Research, Tampa
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(creator_code:org_t)
- ISBN 9789155467739
- Uppsala : Acta Universitatis Upsaliensis, 2007
- English 53 s.
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Series: Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, 1651-6206 ; 216
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Abstract
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- Midgut carcinoid tumours are rare with an incidence of 0.5-2.1/100 000. The primary tumour is usually small and grows slowly but has almost always set metastases at diagnosis. When radically operated, most patients will eventually recur in their disease. We evaluated different methods in detecting recurrent disease in 61 malignant midgut carcinoid tumours that had been radically operated. Thirty-eight patients have been diagnosed with a recurrence. In 32/38 of these patients P-Chromogranin A was the first method to indicate a recurrence. We therefore recommend using P-CgA in the work up in these patients.We investigated characteristics, survival and independent factors that could be of bad prognostic value. We found that in our 284 malignant midgut carcinoid tumours, 208/284 (73%) had distant metastases and 30/284 (11%) had carcinoid heart disease. Median survival was 115.5 months and five-year survival was 77%. In a multivariate analysis liver metastases and carcinoid heart disease were poor prognostic factors.We performed a phase II study with octreotide pamoate investigating the clinical effect in 12 malignant midgut carcinoid tumours in a progressive phase. We found that 9/12 (75%) were stabilised for a median duration of 12 months. We think that this is a good effect considering the advanced stage.We investigated the frequency of four different tyrosine kinase receptors, platelet derived growth factor receptor (PDGR) α and β, epidermal growth factor receptor (EGFR) and c-kit, in 36 malignant midgut carcinoid tumours with immunohistochemistry. We found that 13/34 (38%) tumour samples expressed PDGFRα, 29/33 (88%) PDGFRβ, 24/33 (73%) EGFR, whereas none expressed c-kit. This implicates that midgut carcinoid tumours might be susceptible to treatment with tyrosine kinase receptor inhibitors.
Keyword
- Medicine
- Midgut carcinoid tumour
- Chromogranin A
- Carcinoid heart disease
- Survival
- Octreotide pamoate
- Tyrosine kinase receptors
- Platelet derived growth factor receptor
- Epidermal growth factor receptor
- Medicin
Publication and Content Type
- vet (subject category)
- dok (subject category)
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