Bronchial carcinoid tumors: twenty years' experience

Area of Science:

• Thoracic Surgery
• Surgical Oncology
• Pulmonary Medicine

Background:

• Carcinoid tumors are neuroendocrine neoplasms that can occur in the lungs.
• Surgical resection is the primary treatment for resectable carcinoid tumors.
• Long-term outcomes and the efficacy of lung-sparing resections require further investigation.

Purpose of the Study:

• To evaluate the long-term prognosis of patients undergoing resection for carcinoid tumors.
• To assess the impact of intrathoracic lymphatic metastasis on survival.
• To determine the effectiveness of lung-sparing surgical approaches.

Main Methods:

• Retrospective review of 69 patients with documented carcinoid tumors.
• Analysis of surgical procedures, including pneumonectomy, lobectomy, bilobectomy, segmental resection, and sleeve resection.
• Long-term follow-up data on survival, recurrence, and complications.

Main Results:

• 67 of 69 patients had resectable disease, with no operative deaths.
• 40 patients survived beyond 5 years and 13 beyond 20 years post-resection.
• All 7 patients with lymphatic spread survived disease-free, with 6 followed for 5-24 years.
• Two cases with positive resection margins survived over 20 years.
• All 10 sleeve resections were performed over 5 years ago with successful outcomes.

Conclusions:

• Carcinoid tumor resection is associated with a favorable prognosis, even with resected lymphatic metastases.
• Lung-sparing resections, including sleeve resections, should be prioritized.
• Recurrent pulmonary symptoms warrant thorough investigation for underlying carcinoid tumors.
• Careful biopsy techniques are advised due to potential for hemorrhage.