Variation in Cardiac Screening and Management of Carcinoid Heart Disease in the UK and Republic of Ireland.
Clin Oncol (R Coll Radiol)
; 27(12): 741-6, 2015 Dec.
Article
em En
| MEDLINE
| ID: mdl-26170123
ABSTRACT
AIMS:
Screening for carcinoid heart disease is an important, yet frequently neglected aspect of the management of patients with neuroendocrine tumours (NETs). Screening is advocated in international guidelines, although recommendations on the modality and frequency are poorly defined. We mapped current practice for the screening and management of carcinoid heart disease in specialist NET centres throughout the UK and Republic of Ireland. MATERIALS ANDMETHODS:
Thirty-five NET centres were invited to complete an online questionnaire outlining the size of NET service, patient selection criteria for carcinoid heart disease screening and the modality and frequency of screening.RESULTS:
Twenty-eight centres responded (80%), representing over 5500 patients. Eleven per cent of centres screen all patients with any NET, 14% screen only patients with midgut NETs, 32% screen all patients with liver metastases and/or carcinoid syndrome and 43% screen all patients with evidence of syndrome or raised urinary/serum/plasma 5-hydroxyindoleacetic acid (5HIAA). The mode of screening included clinical examination, echocardiography and biomarker measurement 89% of centres carry out echocardiography, ranging from at initial presentation only (24%), periodically without clearly defined intervals (28%), annually (36%) or less than annually (12%); three centres use a scoring system to report their echocardiograms. Fifty per cent of centres utilise biomarkers for screening (chromogranins, plasma/urinary 5HIAA or most commonly N-terminal pro-brain natriuretic peptide) at varying time intervals.CONCLUSION:
There is considerable heterogeneity across the UK and Ireland in multiple aspects of screening and management of carcinoid heart disease.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Doença Cardíaca Carcinoide
/
Ecocardiografia
/
Biomarcadores
/
Programas de Rastreamento
/
Tumores Neuroendócrinos
/
Gerenciamento Clínico
/
Neoplasias Hepáticas
Idioma:
En
Ano de publicação:
2015
Tipo de documento:
Article