Evaluation of 266 cases of hepatobiliary-pancreatic carcinoids

Abstract

A review was undertaken to clarify the characteristics of carcinoids of the hepatobiliary-pancreatic (HBP) system (in the gallbladder, liver, choledochus, and pancreas) in terms of clinicopathological features, based on information obtained from a statistically reliable number of cases that to date had been unavailable. The material reviewed included 266 cases of HBP carcinoids (239 ordinary and 27 atypical varieties) cited in 338 international articles published in approximately 30 countries since 1920. The details of each case were carefully read and then computerized and analyzed in the analyzing system for gut-pancreatic endocrinoma (Niigata Registry). To avoid duplication, cases without individual identification (such as the age and sex of patients, and the institution providing the mateiials) were excluded. Where thought to be relevant for comparison, cases from the overall gastrointestinal series, consisting of 4789 cases (4606 excluding atypical varieties) similarly input into the same Registry, were referred to for comparative purposes. We found that the characteristics of HBP carcinoids were: female preponderance, except in the choledochus, small lesions (20 mm or less) in the gallbladder and choledochus, and large tumors (exceeding 50mm) in the liver at detection, a higher incidence of hematogenous compared to lymphogenous spread overall, a high incidence of carcinoid syndrome in the pancreas, compared to the other sites, and a relatively unfavorable postoperative prognosis overall.