Standard Treatment If the primary tumor can be removed, radical surgery similar to that for adenocarcinomas may lead to a cure. Isolated metastases in the liver and lung can also be removed.
If the primary tumor cannot be removed, any tumor that is obstructing the bowel can be surgically bypassed. Tumors that can't be removed may also respond to high-dose radiation therapy , occasionally with long-term survival.
Palliation A combined approach using surgery and radiotherapy can help relieve symptoms of pain
and obstruction in patients when metastases can't be removed.
Palliative chemotherapy with doxorubicin , cisplatin , ifosfamide , vincristine or dacarbazine (DTIC) can have response rates of up to 65 percent. Adjuvant chemotherapy may also be given after surgery if the tumor is high-grade, there is a high risk for local recurrence or there is a significant risk of metastasis (lymphatic or blood vessel involvement).
Five-Year Survival About 50 percent if the tumor can be removed surgically
Investigational
• Clinical trials are evaluating the value of new anticancer drugs and biologicals.
• Adjuvant radiotherapy in combination with chemotherapy is being studied.
