Perioperative Carcinoid Crisis During Surgery- Who Benefits from Octreotide? Abstract #1607

Introduction: Carcinoid crisis, as an entity is poorly defined, but can be seen in patients with small bowel NET after open bowel surgery or tumour unrelated procedures as cardiovascular instability (CI)
Aim(s): To audit the incidence of CI during procedures and determine the relationship to perioperative octreotide; considering the patient’s underlying disease burden
Materials and methods: Patients were identified from the pathology database having had their primary tumour resected in our institution between Jan2011 and Dec2015. Our prophylactic octreotide protocol is an IV infusion of 50 µg/hr for 24 hrs prior to surgery
Conference: 14th Annual ENETS conference (2017)
Category: Medical treatment - SMS analogues, interferon
Presenting Author: Khalil Elgendy

To read results and conclusion, please login ...

Further abstracts you may be interested in

#796 Somatostatin Analogues for Preventing Carcinoid Crisis
Introduction: Carcinoid crisis is a life-threating syndrome of neuroendocrine tumors (NETs) and is characterized by dramatic blood pressure fluctuation, arrhythmias, and bronchospasm. Somatostatin analogues (SSTA) have been recommended for prophylactic administration before provocative procedures.
Conference: 11th Annual ENETS Conference (2014)
Category: Medical treatment - SMS analogues, interferon
Presenting Author: LinJie Guo
Authors: Guo L, Tang C
#1296 The Application of Octreotide in a SINET Patient with Carcinoid Syndrome, Carcinoid Heart Disease and Carcinoid Crisis: A Case Report
Introduction: In Chinese population, small intestinal neuroendocrine tumor (SINET) only accounts for 2.2% of gastroenteropancreatic NET, while carcinoid syndrome, carcinoid heart disease (CHD) and carcinoid crisis are rarer.
Conference: 13th Annual ENETS conference (2016)
Category: Clinical cases/reports
Presenting Author: Luohai Chen
Authors: Chen L, Zhang Y, Chen M, Chen J
#2010 A case of Carcinoid Crisis Despite High Dose Somatostatin Analogue Therapy Peri-operatively
Introduction: Carcinoid crisis is a life threatening endocrine emergency. Somatostatin analogues (SSA) are recommended as prophylactic administration before invasive procedures. It remains unclear whether there is an optimal dose of prophylactic somatostatin analogue therapy in the peri-operative period.
Conference: 15th Annual ENETS conference (2018)
Category: Case reports
Presenting Author: Deborah Pitfield
Authors: Pitfield D, Casey R T, Seetho I, Shaw A, ...
#1064 Development of Effective Prophylaxis Against Intraoperative Carcinoid Crisis
Introduction: Patients with foregut and midgut neuroendocrine tumors (NETs) can experience life-threatening carcinoid crises during anesthesia. The prophylactic use of a pre-, intra- and post-operative high dose continuous octreotide infusion was evaluated for its ability to prevent carcinoid crises during cytoreductive surgeries.
Conference: 12th Annual ENETS Conference (2015)
Category: Surgical treatment
Presenting Author: MD Eugene Woltering
Keywords: carcinoid crisis
#18 Long-acting release octreotide induce complete response in type 1 gastric carcinoid tumors
Introduction: Gastric endocrine tumors (GET) are increasingly recognized due to expanding indications of upper gastrointestinal endoscopy. Often silent and benign, GET may also be aggressive when sporadic and may sometimes mimic the course of gastric adenocarcinoma. Current incidence of GETs is estimated at around 8% of digestive endocrine tumors. Yearly age-adjusted incidence is around 0.2 per population of 100,000. Gastric carcinoids (ECLomas) develop from gastric enterochromaffin-like cells (ECL cells) in response to chronically elevated gastrin. Type 1 tumors (ECLomas in the course of atrophic gastritis) may occur in conditions of achlorhydria secondary to auto-immune atrophic fundic gastritis. It occurs mostly in women and they are non-functioning tumors, typically found during upper GI endoscopy performed for dyspepsia. ECLomas present frequently as multiple polyps, usually < 1 cm in diameter in the gastric fundus. Type 1 tumors are almost exclusively benign lesions with little risk of deep invasion of the gastric parietal wall. The neoplastic ECL cells become progressively dedifferentiated with an increasing number of Ki-67 immunoreactive (IR) cell nuclei. In addition, there is a substantial decrease in argynophil and IR NE cells that can be visualized by conventional methods. ECLomas secondary to hypergastrinemia should be closely followed for signs of clinical and histopathological tumor progression. Such ECLomas deserve early, active, radical surgical treatment.
Traditionally, gastric carcinoid type 1 (GCA1s) are endoscopically or surgically removed, depending on the number, appearance and size of the tumors. Antrectomy, with surgical excision of the majority of the G cells, is thought to facilitate regression of these tumors by removing the source of excessive gastrin secretion; however, the long-term benefits of antrectomy still remain uncertain. Although proton pump inhibitors are effective in reducing hypergastrinemia-induced gastric acid hypersecretion in GCA2, they do not affect ECL-cell hyperplasia, and therefore their role in GCA1 is limited. Moreover, in selected cases, significant reduction of hypergastrinemia does not prevent development of ECL carcinoid, suggesting that, in addition to hypergastrinemia, other pathogenic or genetic factors may be involved. Treatment with somatostatin analogues (SSA) might impede ECL-cell hyperplasia by suppressing gastrin secretion and/or by a direct anti-proliferative effect on ECL cells. Treatment with SSAs in GCA1 leads to a substantial tumor load reduction, with a concomitant decrease of serum gastrin levels. Published data indicate an important anti-proliferative effect of SSA on ECL cells, providing clinical benefit and obviating, at least temporarily, the need for invasive therapies for GCA1. Morphometric studies demonstrated that, while antrectomy specifically decreased the volume of ECL cells versus the total volume of endocrine cells, octreotide reduces the overall endocrine cell volume. Although the number of treated patients is small, it has been suggested that SSA may exert important anti-proliferative effects either directly, by inhibiting ECL-cells proliferation, or indirectly through suppression of gastrin hypersecretion.
Conference: 7th Annual ENETS Conference (2010)
Category: Clinical
Presenting Author: MD Ricardo Caponero