- Volume 15 Issue 16
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Somatostatin Analogues Do Not Prevent Carcinoid Crisis
- Guo, Lin-Jie (Department of Gastroenterology, West China Hospital, Sichuan University) ;
- Tang, Cheng-Wei (Department of Gastroenterology, West China Hospital, Sichuan University)
- Published : 2014.08.30
Background: Carcinoid crisis is a life-threating syndrome of neuroendocrine tumors (NETs) characterized by dramatic blood pressure fluctuation, arrhythmias, and bronchospasm. In the era of booming anti-tumor therapeutics, this has become more important since associated stresses can trigger carcinoid crisis. Somatostatin analogues (SSTA) have been recommended for prophylactic administration before intervention procedures for functioning NETs. However, the efficacy is still controversial. The aim of this article is to review efficacy of SSTA for preventing carcinoid crisis. Materials and Methods: PubMed, Cochrane Controlled trials Register, and EMBASE were searched using 'carcinoid crisis' as a search term combining terms with 'somatostatin'; 'octreotide'; 'lanreotide' and 'pasireotide' until December 2013. Results: Twenty-eight articles were retrieved with a total of fifty-three unique patients identified for carcinoid crisis. The most common primary sites of NETs were the small intestine and respiratory tract. The triggering factors for carcinoid crisis included anesthesia/surgery (63.5%), interventional therapy (11.5%), radionuclide therapy (9.6%), examination (7.7%), medication (3.8%), biopsy (2%) and spontaneous (2%). No randomized controlled trials (RCTs) were identified and two case-control studies were included to assess the efficacy of SSTA for preventing carcinoid crisis by meta-analysis. The overall pooled risk of perioperative carcinoid crisis was similar despite the prophylactic administration of SSTA (OR 0.44, 95% CI: 0.14 to 1.35, p=0.15). Conclusions: SSTA wasnot helpful for preventing carcinoid crisis based on a meta-analysis of retrospective studies. Attentive monitoring and careful intervention are essential. Future studies with better quality are needed to clarify any effect of SSTA for preventing carcinoid crisis.
Carcinoid crisis;neuroendocrine tumors;SSTA;prophylaxis
- Ahlman H, Ahlund L, Dahlstrom A, et al (1988a). SMS 201- 995 and provocation tests in preparation of patients with carcinoids for surgery or hepatic arterial embolization. Anesth Analg, 67, 1142-8.
- Ahlman H, Ahlund L, Dahlstrom A, et al (1987). Use of a somatostatin analogue in association with surgery and hepatic arterial embolisation in the treatment of the carcinoid syndrome. Br J Cancer, 56, 840-2. https://doi.org/10.1038/bjc.1987.302
- Ahlman H, Ahlund L, Nilsson O, et al (1988b). Carcinoid tumour cells in long-term culture: release of serotonin but not of tachykinins on stimulation with adrenoceptor agonists. Int J Cancer, 42, 506-10. https://doi.org/10.1002/ijc.2910420407
- Auernhammer CJ, Goke B (2011). Therapeutic strategies for advanced neuroendocrine carcinomas of jejunum/ileum and pancreatic origin. Gut, 60, 1009-21. https://doi.org/10.1136/gut.2009.204453
- Balestrero LM, Beaver CR, Rigas JR (2000). Hypertensive crisis following meperidine administration and chemoembolization of a carcinoid tumor. Arch Intern Med, 160, 2394-5. https://doi.org/10.1001/archinte.160.15.2394
- Bissonnette RT, Gibney RG, Berry BR, et al (1990). Fatal carcinoid crisis after percutaneous fine-needle biopsy of hepatic metastasis: case report and literature review. Radiology, 174, 751-2. https://doi.org/10.1148/radiology.174.3.2406783
- Darby C, Sinclair M, Westaby S (1990). Treatment of a malignant bronchial carcinoid affecting the mediastinum and left atrium by radical two stage resection with cardiopulmonary bypass and somatostatin infusion. Br Heart J, 63, 55-7. https://doi.org/10.1136/hrt.63.1.55
- Davi MV, Bodei L, Francia G, et al (2006). Carcinoid crisis induced by receptor radionuclide therapy with 90Y-DOTATOC in a case of liver metastases from bronchial neuroendocrine tumor (atypical carcinoid). J Endocrinol Invest, 29, 563-7. https://doi.org/10.1007/BF03344149
- De Keizer B, Van Aken MO, Feelders RA, et al (2008). Hormonal crises following receptor radionuclide therapy with the radiolabeled somatostatin analogue [177Lu-DOTA0, Tyr 3] octreotate. Eur J Nucl Med Mol Imag, 35, 749-55. https://doi.org/10.1007/s00259-007-0691-z
- de Vries H, Verschueren RC, Willemse PH, et al (2002). Diagnostic, surgical and medical aspect of the midgut carcinoids. Cancer Treat Rev, 28, 11-25. https://doi.org/10.1053/ctrv.2001.0239
- Debas HT, Mulvihill SJ (1994). Neuroendocrine gut neoplasms. Important lessons from uncommon tumors. Arch Surg, 129, 965-71. https://doi.org/10.1001/archsurg.1994.01420330079015
- Deguchi H, Deguchi K, Tsukada T, et al (1994). Long-term survival in a patient with malignant carcinoid treated with high-dose octreotide. Intern Med, 33, 100-2. https://doi.org/10.2169/internalmedicine.33.100
- Erdem R, Slabbynck H, Van den Branden F (2010). Carcinoid crisis with fatal coronary spasm in a small localized peripheral bronchial carcinoid. Acta Cardiol, 65, 471-5.
- Fujie S, Zhou W, Fann P, et al (2010). Carcinoid crisis 24 hours after bland embolization: a case report. Biosci Trends, 4, 143-4.
- Gillams A, Cassoni A, Conway G, et al (2005). Radiofrequency ablation of neuroendocrine liver metastases: the Middlesex experience. Abdom Imaging, 30, 435-41. https://doi.org/10.1007/s00261-004-0258-4
- Holdcroft A (2000). Hormones and the gut. Br J Anaesth, 85, 58-68. https://doi.org/10.1093/bja/85.1.58
- Janssen M, Salm EF, Breburda CS, et al (2000). Carcinoid crisis during transesophageal echocardiography. Intensive Care Med, 26, 254. https://doi.org/10.1007/s001340050060
- Karmy-Jones R, Vallieres E (1993). Carcinoid crisis after biopsy of a bronchial carcinoid. Ann Thorac Surg, 56, 1403-5. https://doi.org/10.1016/0003-4975(93)90696-F
- Kharrat HA, Taubin H (2003). Carcinoid crisis induced by external manipulation of liver metastasis. J Clin Gastroenterol, 36, 87-8. https://doi.org/10.1097/00004836-200301000-00031
- Kinney MA, Warner ME, Nagorney DM, et al (2001). Perianaesthetic risks and outcomes of abdominal surgery for metastatic carcinoid tumours. Br J Anaesth, 87, 447-52. https://doi.org/10.1093/bja/87.3.447
- Koopmans KP, Brouwers AH, De Hooge MN, et al (2005). Carcinoid crisis after injection of 6-18F-fluorodihydroxyphenylalanine in a patient with metastatic carcinoid. J Nucl Med, 46, 1240-3.
- Kvols LK, Martin JK, Marsh HM, et al (1985). Rapid reversal of carcinoid crisis with a somatostatin analogue. N Engl J Med, 313, 1229-30.
- Kvols LK, Moertel CG, O'Connell MJ, et al (1986). Treatment of the malignant carcinoid syndrome. Evaluation of a longacting somatostatin analogue. N Engl J Med, 315, 663-6. https://doi.org/10.1056/NEJM198609113151102
- Lawrence JP, Ishizuka J, Haber B, et al (1990). The effect of somatostatin on 5-hydroxytryptamine release from a carcinoid tumor. Surgery, 108, 1131-4.
- Lewis MA, Jaramillo S, Roberts L, et al (2012). Hepatic artery embolization for neuroendocrine tumors: Postprocedural management and complications. Oncologist, 17, 725-31. https://doi.org/10.1634/theoncologist.2011-0372
- Lipshutz HG, Kolbeck K, Russel L, et al (2012). Incidence and management of carcinoid crisis during liver directed therapy for metastatic neuroendocrine tumors. J Vascular Intervent Radiology, 23, 577.
- Majeed F, Porter TR, Tarantolo S, et al (2007). Carcinoid crisis and reversible right ventricular dysfunction after embolization in untreated carcinoid syndrome. Eur J Echocardiogr, 8, 386-9. https://doi.org/10.1016/j.euje.2006.04.008
- Marsh HM, Martin JK, Jr., Kvols LK, et al (1987). Carcinoid crisis during anesthesia: successful treatment with a somatostatin analogue. Anesthesiology, 66, 89-91. https://doi.org/10.1097/00000542-198701000-00021
- Massimino K, Harrskog O, Pommier S, et al (2013). Octreotide LAR and bolus octreotide are insufficient for preventing intraoperative complications in carcinoid patients. J Surg Oncol, 107, 842-6. https://doi.org/10.1002/jso.23323
- McPherson A, Regan J, Jackson N (2009). The case report and palliative management of a patient with carcinoid syndrome and crises. J Palliat Med, 12, 743-5. https://doi.org/10.1089/jpm.2009.0068
- Modlin IM, Pavel M, Kidd M, et al (2010). Review article: somatostatin analogues in the treatment of gastroenteropancreatic neuroendocrine (carcinoid) tumours. Aliment Pharmacol Ther, 31, 169-88.
- Moher D, Liberati A, Tetzlaff J, et al (2009). Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med, 6, 1000097. https://doi.org/10.1371/journal.pmed.1000097
- Morrisroe K, Sim IW, McLachlan K, et al (2012). Carcinoid crisis induced by repeated abdominal examination. Intern Med J, 42, 342-4. https://doi.org/10.1111/j.1445-5994.2012.02719.x
- Oberg K, Kvols L, Caplin M, et al (2004). Consensus report on the use of somatostatin analogs for the management of neuroendocrine tumors of the gastroenteropancreatic system. Ann Oncol, 15, 966-73. https://doi.org/10.1093/annonc/mdh216
- Ockert DB, White RD (1988). Anesthetic management of patients with carcinoid heart disease undergoing cardiac surgery: two case reports and a review of previous experience. J Cardiothorac Anesth, 2, 658-65. https://doi.org/10.1016/0888-6296(88)90060-9
- Papadogias D, Makras P, Kossivakis K, et al (2007). Carcinoid syndrome and carcinoid crisis secondary to a metastatic carcinoid tumour of the lung: a therapeutic challenge. Eur J Gastroenterol Hepatol, 19, 1154-9. https://doi.org/10.1097/MEG.0b013e3282294d88
- Parris WCV, Oates JA, Kambam J, et al (1988). Pre-treatment with somatostatin in the anaesthetic management of a patient with carcinoid syndrome. Canadian J Anaesthesia, 35, 413-6. https://doi.org/10.1007/BF03010865
- Parry RG, Glover S, Dudley CR (1996). Acute renal failure associated with carcinoid crisis. Nephrol Dial Transplant, 11, 2489-90. https://doi.org/10.1093/oxfordjournals.ndt.a027221
- Pekarek Z, Skacel Z, Trefny M (1997). The treatment of lifethreatening carcinoid crisis by octreotide (Sandostatin (registered trademark)). Klinicka Onkologie, 10, 20-3.
- Raikhelkar JK, Weiss AJ, Maysick L, et al (2012). Adjuvant therapy with methylene blue in the treatment of postoperative vasoplegic syndrome caused by carcinoid crisis after tricuspid valve replacement. J Cardiothorac Vasc Anesth, 26, 878-9. https://doi.org/10.1053/j.jvca.2011.03.180
- Ramage JK, Ahmed A, Ardill J, et al (2012). Guidelines for the management of gastroenteropancreatic neuroendocrine (including carcinoid) tumours (NETs). Gut, 61, 6-32. https://doi.org/10.1136/gutjnl-2011-300831
- Ramage JK, Davies AH, Ardill J, et al (2005). Guidelines for the management of gastroenteropancreatic neuroendocrine (including carcinoid) tumours. Gut, 54, 1-16.
- Roy RC, Carter RF, Wright PD (1987). Somatostatin, anaesthesia, and the carcinoid syndrome. Peri-operative administration of a somatostatin analogue to suppress carcinoid tumour activity. Anaesthesia, 42, 627-32. https://doi.org/10.1111/j.1365-2044.1987.tb03087.x
- Schmid HA (2008). Pasireotide (SOM230): development, mechanism of action and potential applications. Mol Cell Endocrinol, 286, 69-74. https://doi.org/10.1016/j.mce.2007.09.006
- Shah A, Panchatsharam S, Ashley E (2012). Recurrent acute severe pulmonary oedema as a presentation of carcinoid crisis following cardiac surgery. J Intensive Care Society, 13, 251-5. https://doi.org/10.1177/175114371201300316
- Sinha V, Dyer P, Shuvro RC, et al (2009). Case of carcinoid crisis following a fine-needle biopsy of hepatic metastasis. Eur J Gastroenterol Hepatol, 21, 101-3. https://doi.org/10.1097/MEG.0b013e328300c4f3
- Tomassetti P, Migliori M, Lalli S, et al (2001). Epidemiology, clinical features and diagnosis of gastroenteropancreatic endocrine tumours. Ann Oncol, 12, 95-9.
- Turaga KK, Kvols LK (2011). Recent progress in the understanding, diagnosis, and treatment of gastroenteropancreatic neuroendocrine tumors. CA Cancer J Clin, 61, 113-32. https://doi.org/10.3322/caac.20097
- van Diepen S, Sobey A, Lewanczuk R, et al (2013). A case of acute respiratory distress syndrome responsive to methylene blue during a carcinoid crisis. Can J Anaesth, 60, 1085-8. https://doi.org/10.1007/s12630-013-0026-4
- Wangberg B, Ahlman H, Nilsson O, et al (1990). Amine handling properties of human carcinoid tumour cells in tissue culture. Neurochem Int, 17, 331-41. https://doi.org/10.1016/0197-0186(90)90156-N
- Wangberg B, Nilsson O, Theodorsson E, et al (1991). The effect of a somatostatin analogue on the release of hormones from human midgut carcinoid tumour cells. Br J Cancer, 64, 23-8. https://doi.org/10.1038/bjc.1991.233
- Watson JT, Badner NH, Ali MJ (1990). The prophylactic use of octreotide in a patient with ovarian carcinoid and valvular heart disease. Can J Anaesth, 37, 798-800. https://doi.org/10.1007/BF03006540
- Westberg G, Ahlman H, Nilsson O, et al (1997). Secretory patterns of tryptophan metabolites in midgut carcinoid tumor cells. Neurochem Res, 22, 977-83. https://doi.org/10.1023/A:1022422809202
- Wu BS, Hu Y, Sun J, et al (2014). Analysis on the characteristics and prognosis of pulmonary neuroendocrine tumors. Asian Pac J Cancer Prev, 15, 2205-10. https://doi.org/10.7314/APJCP.2014.15.5.2205
- Yao JC, Hassan M, Phan A, et al (2008). One hundred years after "carcinoid": epidemiology of and prognostic factors for neuroendocrine tumors in 35, 825 cases in the United States. J Clin Oncol, 26, 3063-72. https://doi.org/10.1200/JCO.2007.15.4377
- Yazbek-Karam VG, Haswani RW, Mousallem NM, et al (2009). Severe intra-operative carcinoid crisis in a patient having carcinoid heart disease. Acta Anaesthesiol Scand, 53, 414-5. https://doi.org/10.1111/j.1399-6576.2008.01870.x
- Yucel B, Babacan NA, Kacan T, et al (2013). Survival analysis and prognostic factors for neuroendocrine tumors in Turkey. Asian Pac J Cancer Prev, 14, 6687-92. https://doi.org/10.7314/APJCP.2013.14.11.6687
- Zeng YJ, Liu L, Wu H, et al (2013). Clinicopathological features and prognosis of gastroenteropancreatic neuroendocrine tumors: analysis from a single-institution. Asian Pac J Cancer Prev, 14, 5775-81. https://doi.org/10.7314/APJCP.2013.14.10.5775
- Zimmer C, Kienbaum P, Wiesemes R, et al (2003). Somatostatin does not prevent serotonin release and flushing during chemoembolization of carcinoid liver metastases. Anesthesiology, 98, 1007-11. https://doi.org/10.1097/00000542-200304000-00030
- Expectations of Response from Octreotide Therapy in Recurrent Phosphaturic Mesenchymal Tumors - Do They Reflect Reality? vol.15, pp.24, 2015, https://doi.org/10.7314/APJCP.2014.15.24.10997
- Fatal Systemic Vasoconstriction in a Case of Metastatic Small-Intestinal NET vol.2017, pp.2090-6536, 2017, https://doi.org/10.1155/2017/9810194
- Carcinoid-syndrome pp.1752-296X, 2017, https://doi.org/10.1097/MED.0000000000000376