Little is known about factors related to prognosis in patients with carcinoid disease.
In this study we have tried to identify such factors.
We have evaluated 301 consecutive carcinoid patients (256 midgut, 39 foregut and six
hindgut) referred during 15 years for medical treatment with respect to tumor distribution,
hormone production, prognostic factors and survival.
Survival was significantly shorter in midgut carcinoid patients with > or = 5 liver
metastases or with high levels of urinary 5-hydroxyindoleacetic acid, plasma chromogranin
A or neuropeptide K. By univariate analysis, these variables together with the presence
of carcinoid syndrome were related to a higher risk of dying. In multivariate analyses,
performed in the 71 patients with full information on all variables, advanced age
and plasma chromogranin A > 5000 micrograms/l were independent predictors of overall
Poor prognostic factors for midgut carcinoid patients were multiple liver metastases,
presence of carcinoid syndrome and high levels of the tumor markers studied. In this
study the only independent predictors of bad prognosis in midgut, carcinoid patients
were advanced age, which however is inherently related to overall survival, and plasma
chromogranin A > 5000 micrograms/l. Thus, chromogranin A may prove to be an important
prognostic marker for patients with carcinoid tumors.