title: Surgery in the management of mediastinal carcinoid.
abstract: Primary carcinoid tumors of the mediastinum were described for the first time in 1972 as thymic carcinoids. Our experience with 16 patients who underwent diagnostic and surgical procedures at the Mayo Clinic is presented. All of these patients had mediastinal carcinoid. The surgical procedures included node biopsy, anterior mediastinotomy (Chamberlain), median sternotomy and posterior lateral thoracotomy. Complete resection was possible in 9 (56.3%) patients, 3 (18.7%) had partial removal (debulking), and 4 (25%) had diagnostic biopsies only. The operative morbidity was 25%. There were no postoperative deaths. In resectable patients, the average disease free interval was 45.7 months. Five year and ten year survival was 47% and 22%, respectively. Local or distant metastatic spread developed in all patients (100%). Mediastinal carcinoids are a separate entity from other thymic and mediastinal neoplasms. (We suggest that) Surgical excision may be possible earlier in the disease and radiation and chemotherapy are of doubtful value.
authors.affiliation: Mayo Clinic, Rochester, Minnesota, USA.
authors.forename: L A
authors.initials: LA
authors.lastname: Best
authors.forename: B M
authors.initials: BM
authors.lastname: Westbrook
authors.forename: V F
authors.initials: VF
authors.lastname: Trastek
authors.forename: W S
authors.initials: WS
authors.lastname: Payne
authors.forename: P C
authors.initials: PC
authors.lastname: Pairolero
mesh_terms: D000328:Adult; D000368:Aged; D002276:Carcinoid Tumor / Q000401:mortality / Q000556:secondary / Q000601:surgery*; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008479:Mediastinal Neoplasms / Q000401:mortality / Q000601:surgery*; D008875:Middle Aged; D037981:Neck Dissection; D009362:Neoplasm Metastasis; D009364:Neoplasm Recurrence, Local / Q000601:surgery; D011183:Postoperative Complications; D012086:Reoperation; D016019:Survival Analysis; D013997:Time Factors