Patient selection: carcinoid tumor
Carcinoid locations:
(1) Foregut: bronchus, stomach, proximal duodenum, pancreas
(2) Midgut: distal duodenum to mid-transverse colon
(3) Hindgut: mid-transverse colon to anus
Midgut carcinoid tumors are the most common.
The median survival of a patient with a foregut or hindgut carcinoid tumor after start of therapy is shorter than for a patient with a midgut carcinoid tumor.
Poor prognostic factors for patients with a midgut carcinoid tumor from multivariate analysis:
(1) plasma chromogranin A concentration > 5,000 micrograms per liter
(2) older age (>= 53 years)
Additional prognostic factors for a midgut carcinoid tumor:
(1) multiple (>= 5) liver metastases
(2) carcinoid syndrome
(3) high urine levels of 5-hydorxyindoleacetic acid (5-HIAA)
