What are the NCCN recommendations for the treatment of bowel carcinoid tumors?

Updated: Feb 12, 2019
  • Author: Cameron K Tebbi, MD; Chief Editor: Max J Coppes, MD, PhD, MBA  more...
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Answer

NCCN recommendations are as follows [103] :

  • Surgical resection with lymphadenectomy

  • Careful examination of the entire bowel and assessment of proximity to or involvement of the superior mesenteric artery and superior mesenteric vein

  • Prophylactic cholecystectomy if further treatment with octreotide or lanreotide is planned

The NANETS guidelines include the following recommendations [108] :

  • Tumors of the cecum: Right hemicolectomy with node dissection

  • Tumors of the jejunal or ileum: Resection with node dissection; full bowel examination required

  • Distal colon and rectum tumors <1 cm: Endoscopic resection (polypectomy, endoscopic mucosal resection, endoscopic submucosal dissection) for mucosal or submucosal tumors

  • Distal colon and rectum tumors 1-2 cm: Transanal excision via rigid or flexible dissection; could also be considered after endoscopic resection with positive margins

  • Distal colon and rectum tumors >2 cm: Surgical resection (low anterior resection or abdominoperineal resection) for larger tumors, tumors invading muscularis propria, or those with lymphadenopathy


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