Long-Term Survival after Resection for Primary Hepatic Carcinoid Tumor

From the Departments of Surgery (CDK, CDA, RBA, CWP) and Pathology (LWL), Vanderbilt University Medical Center, Nashville, Tennessee.

Address correspondence and reprint requests to: Clayton D. Knox, Division of Hepatobiliary Surgery and Liver Transplantation, Oxford House, Suite 801, Vanderbilt University Medical Center, Nashville, TN 37232-4753; Fax: 615-343-1355.

	Abstract

Background: Primary hepatic carcinoid tumors (PHCTs) are extremely rare, and fewer than 50 cases have been reported in the English-language literature. We report a patient with a PHCT and review the cases in the literature.

Methods: Our patient presented with symptoms and underwent liver resection for PHCT and regional lymph node metastasis. He underwent two more liver resections over the following 7 years for recurrent PHCT. Cases reported in the English-language literature were reviewed and survival analysis was performed with the Kaplan-Meier method. The survival impacts of age, gender, tumor foci, extrahepatic metastasis, unilobar versus bilobar disease, and type of preoperative treatment were determined by means of log-rank test.

Results: Our patient has been free of symptoms for 14 years of follow-up and free of disease for 8 years of follow-up. Forty-eight cases of PHCT were found in the literature, and 92% of these patients underwent resection. Actuarial 5- and 10-year survival for all patients was 78% and 59%, respectively, whereas for resected patients, 10-year survival was 68%. The administration of preoperative chemotherapy, radiation therapy, or chemoembolization did not impact survival, nor did age, gender, presence of extrahepatic metastasis, number of tumors, or distribution of the tumor within the liver.

Conclusions: Resection is the treatment of choice for PHCT and has provided favorable outcomes. Resection for PHCT can be performed in most patients and offers long-term survival.

Key Words: Carcinoid, Liver, Neuroendocrine neoplasm, Primary, Resection.

This article has been cited by other articles:

				J. C. Yao and J.-N. Vauthey Primary and Metastatic Hepatic Carcinoid: Is There an Algorithm? Ann. Surg. Oncol., December 1, 2003; 10(10): 1133 - 1135. [Full Text] [PDF]