The prevalence, operations, and outcomes of carcinoid heart disease

Rebekah Macfie; Belinda H. McCully; Anna N. Ratzlaff; James Lim; Howard K. Song; Elizabeth N. Dewey; Su Ellen J. Pommier; Castigliano M. Bhamidipati; Rodney F. Pommier

doi:10.1016/j.amjsurg.2022.03.054

The prevalence, operations, and outcomes of carcinoid heart disease

Rebekah Macfie, Belinda H. McCully, Anna N. Ratzlaff, James Lim, Howard K. Song, Elizabeth N. Dewey, Su Ellen J. Pommier, Castigliano M. Bhamidipati, Rodney F. Pommier

Research output: Contribution to journal › Article › peer-review

7 Scopus citations

Abstract

Background: Carcinoid heart disease (CHD) is a sequela of carcinoid liver metastases (LM). The true prevalence of CHD is unknown due to infrequent screening by transthoracic echocardiography (TTE). Octreotide is believed to protect against new and recurrent CHD, but supporting data are scant. This study determined CHD prevalence and outcomes in patients screened by TTE and treated with octreotide. Methods: Records of carcinoid patients from 2001 to 2021 were reviewed. Survival was estimated by Kaplan-Meyer curves and compared by log-rank. Results: Among 282 patients screened by TTE, overall survival was lower in CHD (n = 40) versus non-CHD (n = 242) patients (p < 0.001). Despite octreotide therapy, 21 patients developed CHD. Among patients with inoperable LM, survival was lower in CHD patients without valve replacement (VR) (p < 0.001), but similar between CHD patients with VR and non-CHD patients. CHD patients with VR and hepatic cytoreduction had survival similar to CHD patients without VR. Conclusion: VR improves survival in CHD patients with inoperable LM. Hepatic cytoreduction after VR should be reserved for carefully selected cases. Our data do not support a protective effect of octreotide.

Original language	English (US)
Pages (from-to)	665-669
Number of pages	5
Journal	American journal of surgery
Volume	224
Issue number	2
DOIs	https://doi.org/10.1016/j.amjsurg.2022.03.054
State	Published - Aug 2022

ASJC Scopus subject areas

Surgery

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10.1016/j.amjsurg.2022.03.054

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@article{4002ffb0bae24a1580e18491c23e6821,

title = "The prevalence, operations, and outcomes of carcinoid heart disease",

abstract = "Background: Carcinoid heart disease (CHD) is a sequela of carcinoid liver metastases (LM). The true prevalence of CHD is unknown due to infrequent screening by transthoracic echocardiography (TTE). Octreotide is believed to protect against new and recurrent CHD, but supporting data are scant. This study determined CHD prevalence and outcomes in patients screened by TTE and treated with octreotide. Methods: Records of carcinoid patients from 2001 to 2021 were reviewed. Survival was estimated by Kaplan-Meyer curves and compared by log-rank. Results: Among 282 patients screened by TTE, overall survival was lower in CHD (n = 40) versus non-CHD (n = 242) patients (p < 0.001). Despite octreotide therapy, 21 patients developed CHD. Among patients with inoperable LM, survival was lower in CHD patients without valve replacement (VR) (p < 0.001), but similar between CHD patients with VR and non-CHD patients. CHD patients with VR and hepatic cytoreduction had survival similar to CHD patients without VR. Conclusion: VR improves survival in CHD patients with inoperable LM. Hepatic cytoreduction after VR should be reserved for carefully selected cases. Our data do not support a protective effect of octreotide.",

author = "Rebekah Macfie and McCully, {Belinda H.} and Ratzlaff, {Anna N.} and James Lim and Song, {Howard K.} and Dewey, {Elizabeth N.} and Pommier, {Su Ellen J.} and Bhamidipati, {Castigliano M.} and Pommier, {Rodney F.}",

note = "Publisher Copyright: {\textcopyright} 2022 Elsevier Inc.",

year = "2022",

month = aug,

doi = "10.1016/j.amjsurg.2022.03.054",

language = "English (US)",

volume = "224",

pages = "665--669",

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publisher = "Elsevier Inc.",

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T1 - The prevalence, operations, and outcomes of carcinoid heart disease

AU - Macfie, Rebekah

AU - McCully, Belinda H.

AU - Ratzlaff, Anna N.

AU - Lim, James

AU - Song, Howard K.

AU - Dewey, Elizabeth N.

AU - Pommier, Su Ellen J.

AU - Bhamidipati, Castigliano M.

AU - Pommier, Rodney F.

PY - 2022/8

Y1 - 2022/8

N2 - Background: Carcinoid heart disease (CHD) is a sequela of carcinoid liver metastases (LM). The true prevalence of CHD is unknown due to infrequent screening by transthoracic echocardiography (TTE). Octreotide is believed to protect against new and recurrent CHD, but supporting data are scant. This study determined CHD prevalence and outcomes in patients screened by TTE and treated with octreotide. Methods: Records of carcinoid patients from 2001 to 2021 were reviewed. Survival was estimated by Kaplan-Meyer curves and compared by log-rank. Results: Among 282 patients screened by TTE, overall survival was lower in CHD (n = 40) versus non-CHD (n = 242) patients (p < 0.001). Despite octreotide therapy, 21 patients developed CHD. Among patients with inoperable LM, survival was lower in CHD patients without valve replacement (VR) (p < 0.001), but similar between CHD patients with VR and non-CHD patients. CHD patients with VR and hepatic cytoreduction had survival similar to CHD patients without VR. Conclusion: VR improves survival in CHD patients with inoperable LM. Hepatic cytoreduction after VR should be reserved for carefully selected cases. Our data do not support a protective effect of octreotide.

AB - Background: Carcinoid heart disease (CHD) is a sequela of carcinoid liver metastases (LM). The true prevalence of CHD is unknown due to infrequent screening by transthoracic echocardiography (TTE). Octreotide is believed to protect against new and recurrent CHD, but supporting data are scant. This study determined CHD prevalence and outcomes in patients screened by TTE and treated with octreotide. Methods: Records of carcinoid patients from 2001 to 2021 were reviewed. Survival was estimated by Kaplan-Meyer curves and compared by log-rank. Results: Among 282 patients screened by TTE, overall survival was lower in CHD (n = 40) versus non-CHD (n = 242) patients (p < 0.001). Despite octreotide therapy, 21 patients developed CHD. Among patients with inoperable LM, survival was lower in CHD patients without valve replacement (VR) (p < 0.001), but similar between CHD patients with VR and non-CHD patients. CHD patients with VR and hepatic cytoreduction had survival similar to CHD patients without VR. Conclusion: VR improves survival in CHD patients with inoperable LM. Hepatic cytoreduction after VR should be reserved for carefully selected cases. Our data do not support a protective effect of octreotide.

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The prevalence, operations, and outcomes of carcinoid heart disease

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