{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T03:30:01Z","timestamp":1785295801144,"version":"3.55.0"},"reference-count":0,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[1996,7,1]],"date-time":"1996-07-01T00:00:00Z","timestamp":836179200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[1996,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Sixty\u2010four consecutive patients with disseminated midgut carcinoids were treated during an 8\u2010year period according to a single clinical protocol aimed at aggressive tumor reduction by surgery alone or with subsequent hepatic artery embolization. All patients had markedly elevated urinary 5\u2010hydroxyindoleacetic acid (5\u2010HIAA) levels (581 \u00b1 79 \u03bcmol\/24 h) and hormonal symptoms. Fourteen patients (22%) reached anatomic and biochemical cure by surgery alone. At follow\u2010up, the mean 5\u2010HIAA levels were still normal after 69.0 \u00b1 6.2\u00a0months; two patients had died from unrelated causes. With the introduction of somatostatin receptor scintigraphy, subclinical disease was diagnosed in 7 of these 14 patients. Forty patients with bilobar hepatic disease underwent embolization in combination with octreotide. In this group, 5\u2010HIAA levels were still reduced by 55% after 71 \u00b1 11\u00a0months of follow\u2010up, and the 5\u2010year survival was 56%, estimated from the total death hazard function. After embolization, two subgroups could be identified with marked differences in their long\u2010term response to treatment. Ten patients were not embolized owing to complicating diseases. The 5\u2010year survival for the entire series was 58%. A significantly increased risk of cardiovascular deaths was seen, which underlines the importance of total survival analysis in a disease with multiple hormonal effects. It is concluded that an active surgical approach must be recommended to patients with the midgut carcinoid syndrome. In patients with bilobar hepatic disease, embolization combined with octreotide treatment markedly reduced the 5\u2010HIAA excretion and suggested a prolonged 5\u2010year survival.<\/jats:p>","DOI":"10.1007\/s002689900136","type":"journal-article","created":{"date-parts":[[2002,8,25]],"date-time":"2002-08-25T05:57:49Z","timestamp":1030255069000},"page":"892-899","source":"Crossref","is-referenced-by-count":83,"title":["Survival of Patients with Disseminated Midgut Carcinoid Tumors after Aggressive Tumor Reduction"],"prefix":"10.1002","volume":"20","author":[{"given":"B.","family":"W\u00e4ngberg","sequence":"first","affiliation":[{"name":"Department of Surgery Sahlgrenska University Hospital S\u2010413 45 G\u00f6teborg Sweden<!--<country1>SE<\/country1>-->"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G.","family":"Westberg","sequence":"additional","affiliation":[{"name":"Department of Surgery Sahlgrenska University Hospital S\u2010413 45 G\u00f6teborg Sweden<!--<country1>SE<\/country1>-->"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"U.","family":"Tyl\u00e9n","sequence":"additional","affiliation":[{"name":"Department of Radiology Sahlgrenska University Hospital S\u2010413 45 G\u00f6teborg Sweden<!--<country1>SE<\/country1>-->"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L.\u2010E.","family":"Tisell","sequence":"additional","affiliation":[{"name":"Department of Surgery Sahlgrenska University Hospital S\u2010413 45 G\u00f6teborg Sweden<!--<country1>SE<\/country1>-->"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Jansson","sequence":"additional","affiliation":[{"name":"Department of Surgery Sahlgrenska University Hospital S\u2010413 45 G\u00f6teborg Sweden<!--<country1>SE<\/country1>-->"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"O.","family":"Nilsson","sequence":"additional","affiliation":[{"name":"Department of Pathology Sahlgrenska University Hospital S\u2010413 45 G\u00f6teborg Sweden<!--<country1>SE<\/country1>-->"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"V.","family":"Johansson","sequence":"additional","affiliation":[{"name":"Department of Surgery Sahlgrenska University Hospital S\u2010413 45 G\u00f6teborg Sweden<!--<country1>SE<\/country1>-->"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T.","family":"Scherst\u00e9n","sequence":"additional","affiliation":[{"name":"Department of Surgery Sahlgrenska University Hospital S\u2010413 45 G\u00f6teborg Sweden<!--<country1>SE<\/country1>-->"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H.","family":"Ahlman","sequence":"additional","affiliation":[{"name":"Department of Surgery Sahlgrenska University Hospital S\u2010413 45 G\u00f6teborg Sweden<!--<country1>SE<\/country1>-->"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[1996,7]]},"container-title":["World Journal of Surgery"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1007\/s002689900136.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/article\/10.1007\/s002689900136\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1007\/s002689900136","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,1,11]],"date-time":"2024-01-11T16:12:51Z","timestamp":1704989571000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1007\/s002689900136"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1996,7]]},"references-count":0,"journal-issue":{"issue":"7","published-print":{"date-parts":[[1996,7]]}},"alternative-id":["10.1007\/s002689900136"],"URL":"https:\/\/doi.org\/10.1007\/s002689900136","archive":["Portico"],"relation":{},"ISSN":["0364-2313","1432-2323"],"issn-type":[{"value":"0364-2313","type":"print"},{"value":"1432-2323","type":"electronic"}],"subject":[],"published":{"date-parts":[[1996,7]]}}}