Surgical therapy for small-bowel carcinoid tumors.

Eighty-two symptomatic patients with carcinoid tumors of the small intestine were examined and treated over a 20-year period. Common clinical features included weight loss, diarrhea, and symptoms of intermittent bowel obstruction; 25 patients (30%) exhibited the carcinoid syndrome. Multiple carcinoid tumors occurred in 23 patients (28%), and hepatic metastases were present in 30 (37%). All patients underwent operation. The overall mortality was 7%, and the cumulative five-year survival rate was 59%. Two factors influenced prognosis after operation: hepatic metastases and incomplete resection. Other variables, including the sex and age of the patient and the size of the primary tumor, were of no additional prognostic value. Wide resection of the tumor, including regional lymph nodes, is indicated, regardless of the size of the primary tumor.