Small bowel carcinoid: Location isn’t everything!

AIM: To investigate the prognostic significance of the primary site of disease for small bowel carcinoid(SBC) using a population-based analysis.METHODS: The Surveillance,Epidemiology and End Results(SEER) database was queried for histologically confirmed SBC between the years 1988 and 2009.Overall survival(OS) and disease-specific survival(DSS) were analyzed using the Kaplan-Meier method and compared using Log rank testing.Log rank and multivariate Cox regression analyses were used to identify predictors of survival using age,year of diagnosis,race,gender,tumor histology/size/location,tumor-node-metastasis stage,number of lymph nodes(LNs) examined and percent of LNs with metastases.RESULTS: Of the 3763 patients,51.2% were male with a mean age of 62.13 years.Median follow-up was 50 mo.The 10-year OS and DSS for duodenal primaries were significantly better when compared to jejunal and ileal primaries(P = 0.02 and < 0.0001,respectively).On multivariate Cox regression analysis,after adjusting for multiple factors,primary site location was not a significant predictor of survival(P = 0.752 for OS and P = 0.966 DSS) while age,number of primaries,number of LNs examined,T-stage and M-stage were independent predictors of survival.CONCLUSION: This 21-year,population-based study of SBC challenges the concept that location of the primary lesion alone is a significant predictor of survival.