Exploring the carcinoid crisis: insights from a cancer-specific centre.

Fecha de publicación: 02/12/2025 Fecha Ahead of Print: 02/12/2025

Autores de IIS La Fe

María Isabel Del Olmo García

Autor

Participantes ajenos a IIS La Fe

Kong G
Wong H
Michael M
Ismail H
Nip WF
Pasanen L
Chiang C

Grupos

Unidad Mixta de Investigación en Endocrinología, Nutrición y Dietética clínica

Abstract

OBJECTIVE: To assess the prevalence, pre-procedure biomarkers, and management of carcinoid crisis (CC) in a cancer-specific hospital. DESIGN: Retrospective observational study of subjects with carcinoid syndrome (CS) undergoing invasive procedures or systemic therapies over 5 years. METHODS: Electronic haemodynamic parameters and patient records were extracted. CC incidence was assessed using strict (SBP <80 mmHg, >10 min) or broad criteria (severe hypotension, hypertension, arrhythmias, >1 min). RESULTS: 48 patients with CS underwent 71 procedures (35 invasive procedures, 36 systemic therapies). CC did not occur during systemic therapies. Prophylactic octreotide infusion was used in 63% of invasive procedures. CC occurred in 43% of procedures as defined by broad criteria and in 20% as defined by strict criteria. Compared to those without CC, patients with strictly defined CC had higher chromogranin A (P < 0.001), higher 5-HIAA (P = 0.03), higher BNP (P = 0.03), longer hospital stay (P < 0.001), and higher postoperative complications (P < 0.001). Lower intraoperative mean arterial pressure (MAP) correlated with postoperative complications (? = -0.55, P = 0.004) and longer hospital stay (? = -0.62, P = 0.001). All subjects with strictly defined CC were treated with more than one drug; however, there were five patients with broadly defined CC who did not require treatment for transient haemodynamic instability. CONCLUSIONS: Pre-operative biomarker assessment is essential to triage CS patients at risk of CC and thereafter trigger a risk-based management pathway. Prolonged intraoperative hypotension correlated best with postoperative outcomes, and is a better definition for CC in our cohort.

Datos de la publicación

ISSN/ISSNe:: 2634-4793, 2634-4793
Tipo:: Article
Páginas:: 250034-250034
DOI:: 10.1530/EO-25-0034
PubMed:: 41358255

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Filiaciones

Del Olmo-García M:: Department of Endocrinology and Nutrition, University and Polytechnic Hospital La Fe, Valencia, Spain

Department of Medicine, University of Valencia, Valencia, Spain
Kong G:: Department of Molecular Imaging and Therapeutic Nuclear Medicine, Peter MacCallum Cancer Centre, Melbourne, Australia

Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Australia
Wong H:: Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Australia

Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, Australia
Michael M:: Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Australia

Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, Australia
Ismail H:: Department of Anaesthetics, Peter MacCallum Cancer Centre, Melbourne, Australia
Nip WF:: Department of Molecular Imaging and Therapeutic Nuclear Medicine, Peter MacCallum Cancer Centre, Melbourne, Australia
Pasanen L:: Department of Molecular Imaging and Therapeutic Nuclear Medicine, Peter MacCallum Cancer Centre, Melbourne, Australia
Chiang C:: Department of Internal Medicine, Peter MacCallum Cancer Centre, Parkville, Australia

Department of Diabetes and Endocrinology, Melbourne Health, University of Melbourne, Parkville, Australia

Keywords

carcinoid; carcinoid crisis; neuroendocrine tumour; somatostatin analogues

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