Early diagnosis and prognosis
No general early detection measures have been established for the randomly (sporadically) occurring gastrointestinal carcinoid tumors and islet cell tumors of the pancreas. However, carcinoid tumors of the stomach, duodenum and, above all, the rectum are increasingly being detected at an early stage. Thanks to an increase in early detection and new treatment modalities, the patient's prognosis has improved greatly over the past 30 years. For patients with well-differentiated carcinoids of the stomach, small intestines, rectum, appendix, or with G1 well-differentiated (Ki-67<2%) islet cell tumors of the pancreas, five year survival rates of 75% and higher are being reported from specialized centers.
The widespread use of gastrointestinal endoscopy, i.e. colonoscopy, esophagogastro-duodenoscopy or endoscopic ultrasound , and of X-ray examinations such as computed tomography, have led to an increase of early detected neuroendocrine tumors. Thus, carcinoids of the rectum are nowadays in general detected "en passant" by screening colonoscopy which was introduced for the detection and prevention of colorectal cancer (adenocarcinoma of the colon and rectum). The same holds true for the early detection of gastric or duodenal carcinoids often found by an endoscopy (esophagogastroduodenoscopy) that was ordered for some other reason.
Different from the situation in sporadic neuroendocrine tumor disease, early detection of the very rare hereditary neuroendocrine tumors, in particular of multiple endocrine neoplasia type 1 (MEN1), is indeed possible and is recommended. The tumors (in MEN1 gene carriers, MEN1 families) are detected early by using the history of complaints, laboratory tests (hormone determination) and imaging techniques (X-ray, ultrasound, endoscopic examinations).
Contact
Center of Neuroendocrine Tumors
Prof. Dr. med. Hans Scherübl
Vivantes Klinikum Am Urban
Academic Teaching Hospital of Charité-University Medicine, Berlin
Dieffenbachstraße 1
10967 Berlin, Germany
Tel: + 49 30 130 225201
Fax: + 49 30 130 225205
Email: This email address is being protected from spambots. You need JavaScript enabled to view it.
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