Surgical and Chemotherapy Treatment Outcomes of Goblet Cell Carcinoid: A Tertiary Cancer Center Experience |
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Authors: | Tuan H Pham MD PhD Bruce Wolff MD Susan C Abraham MD Ernesto Drelichman MD |
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Institution: | (1) Department of Colorectal Surgery, Mayo Clinic, 200 First Street S.W., Rochester, Minnesota, 55905;(2) Department of Pathology, Mayo Clinic, 200 First Street S.W., Rochester, Minnesota, 55905;(3) Department of Surgery, University of Alabama at Birmingham, KB417, 1530 3rd Avenue South, Birmingham, Alabama, 35294 |
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Abstract: | Background Goblet cell carcinoid (GCC) is a rare malignant tumor with distinct histological and clinical features. Our goals were to
review the surgical and chemotherapy outcomes of patients with GCC.
Methods We performed a retrospective review of the Mayo Clinic database from 1984 to 2004 with a prospective follow-up of 57 patients
with GCC.
Results The age at diagnosis (mean ± SE) was 55 ± 13 years. The most common presentations were right lower quadrant pain mimicking
appendicitis (70%) and right lower quadrant or pelvic mass (25%). Only patients with T4 lesions had positive mesenteric nodes,
with a frequency of 28%. Fifty percent of female patients had metastasis to the ovaries. The disease-specific 5-year survivals
for stages I, II, III, and IV were 100%, 76%, 22%, and 14%, respectively; the overall mean survival was 47 ± 3 months. All
stage I patients had simple appendectomy. The overall 5-year survival rates for patients with combined stages II to IV who
underwent appendectomy versus right hemicolectomy were 43% and 34%, respectively (P = .604). The corresponding survival rates for adjuvant chemotherapy versus no chemotherapy were 32% and 27%, respectively
(P = .151).
Conclusions The prognosis for patients with GCC tumors correlates well with the American Joint Committee on Cancer stage at initial presentation.
Appendectomy alone seems adequate for stage I disease. For staging purposes, right hemicolectomy is appropriate for T4 tumors
or stage II to III disease provided that it can be performed with minimal risk. Surgical debulking is a consideration but
is controversial. Adjuvant chemotherapy with 5-fluorouracil and leucovorin regimen is minimally effective against GCC. |
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Keywords: | Goblet cell carcinoid Adenocarcinoid Small-bowel neoplasms Appendix |
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