Intestinal Carcinoid Tumor Follow-up

Updated: Mar 02, 2017
  • Author: Hemant Singhal, MD, MBBS, MBA, FRCS(Edin), FRCS, FRCSC; Chief Editor: N Joseph Espat, MD, MS, FACS  more...
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Follow-up

Further Outpatient Care

Surveillance of treated carcinoid patients depends on the initial stage at presentation and the type of treatment that was offered, as follows:

  • For appendicular carcinoids that are less than 2 cm and localized to the appendix, no further follow-up is required after the patients have had an appendicectomy
  • For those patients who have had a right hemicolectomy, blood markers (5-HIAA, chromogranin A) need to be monitored at 3 months after resection, along with imaging in the form of a CT scan or MRI
  • For rectal carcinoids 2 cm or less, which have been amenable to transanal excision, follow-up is required in the form of a proctoscopy at 6 and 12 months, and further investigations are warranted only if clinically indicated
  • For other people with intestinal carcinoid tumors, long-term monitoring is required. This involves blood markers every 6 months for the first 3 years and then yearly thereafter; additional imaging is performed based on the results of the markers and clinical findings [26]
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Prognosis

In certain patients, aggressive operative extirpation of neuroendocrine neoplasm hepatic metastases allows for long-term survival. [37] However, disease progression is still common. Thus, a multimodality treatment approach is needed in patients with progressive disease. Combining knowledge of identified prognostic factors can improve patient selection and can help identify patients at greatest risk for treatment failure.

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