Carcinoid tumors with regional metastasis or local extension should be treated by aggressive surgery. If all visible malignant disease can be removed, long-term survival rates will be excellent.
No surgical adjuvant treatment is known to be helpful.
If the regional disease can't be removed, palliative surgery—to remove all the accessible disease, for example—should be carried out.
Chemotherapy is not required until significant symptoms occur, for these patients frequently have many months or even years of comfortable life without further treatment.
Metastatic Carcinoid Tumors
A number of standard treatment options are available for metastatic carcinoid tumors.
Surgery This may sometimes be of considerable value when there are large liver metastases
involving surgically accessible areas of the liver. Liver metastases that recur after surgery should be considered for another resection if they are in an area where the operation can be done with minimal complications.
• For very carefully selected patients with slowly progressive disease and symptomatic carcinoid heart disease,
