However, the groups did not differ with regards to the incidence of liver metastases and are therefore considered comparable in terms of disease stage at the time of referral. The 3- and 5-year survival rates did not differ considerably between the two groups despite the fact that more patients in group 2 had http://www.selleckchem.com/products/MLN8237.html a successful surgery and a higher number of patients were treated with RFA. Radionuclide treatment was initiated in 2004 as a second- or third-line therapy and thus used late in the clinical course and has shown promising effects in several studies [8�C10]. The same proportion of patients had radionuclide treatment, and it is possible that the effect of radionuclide treatment on the survival of our patients will appear after a longer period of followup, relevant for group 2 patients.

The overall 5-year survival rate of all small intestinal NET patients in the two time periods was 71%. Other studies found 5-year survival rates of 60.5%�C75% [11�C15]. Direct comparison of survival rates is, however, difficult due to differences in tumour classification and patient cohorts. Some studies [12] report on midgut carcinoid tumours; which is a formerly used term comprising tumours from the distal duodenum to the midtransverse colon and so may also encompass tumours originating in the appendix. Appendiceal NETs have an excellent prognosis with reported disease-specific five-year survival rates of 89%�C95% [13, 16, 17]. Survival rates for midgut carcinoid tumours as a group are therefore likely to be higher than the specific survival rates for patients with true small intestinal NET.

Bergestuen et al. [14] compared the overall 5-year survival in their group of patients (72%) with the expected survival in the general population and observed a relative 5-year survival rate of 78%. In groups 1 and 2, 80.8% and 75.2% of patients, respectively, had Entinostat a primary surgery performed after the initial evaluation. Of these patients, 19% in group 1 and 56% in group 2 were considered macroscopically radically operated. Patients in both groups with macroscopically radical surgery performed had a higher 5-year survival rate compared to patients in the same group without radical surgery performed. This observation is in line with the finding of Pape et al., where patients with radical tumour resection had a more favourable prognosis compared to the whole group of patients [15]. A similar observation was made by Hellman et al. [18]. This study only comprised patients with true primary tumour in the small intestine, and we excluded patients with unknown primary tumour. However, in some cases of NET of unknown origin, the primary tumour is later identified in the small intestine [7].