title: Pulmonary carcinoid: presentation, diagnosis, and outcome in 142 cases in Israel and review of 640 cases from the literature.
abstract: OBJECTIVE
  To determine the characteristic features and outcome of pulmonary carcinoid tumors in Israel.
  
  
  METHODS
  Retrospective analysis of the clinicopathologic data and outcome of patients from four major hospitals in Israel in the last 20 years.
  
  
  RESULTS
  There were 142 cases of pulmonary carcinoid tumors: typical (n = 128) and atypical (n = 14). We calculated an annual incidence of about 2.3 to 2.8 cases per 1 million population. The ratio of female to male patients was 1.6:1. The prevalence of smoking was similar to the general population in patients with typical carcinoids and twice as high in the atypical group. Bronchial obstruction was the cause of most of the presenting symptoms and signs and included obstructive pneumonitis, pleuritic pain, atelectasis, and dyspnea (41%). Carcinoid syndrome was extremely rare and occurred in only one patient with metastatic disease. Most of the tumors (68%) arose in the major bronchi. Diagnosis was made using fiberoptic bronchoscopy in 52% of patients without evidence of endobronchial hemorrhage. Nodal involvement and distant metastases occurred in 57% and 21%, respectively, in the atypical group, and 10% and 3%, respectively, in the typical group. The treatment of choice was surgical: lobectomy (56%) or pneumonectomy (16%). The respective 5-year survival rates for patients with typical and atypical tumors were 89% and 75% (not significant), and the 10-year survival rates were 82% and 56% (p < 0.05). A review of large series from the literature is presented.
  
  
  CONCLUSIONS
  Pulmonary carcinoid is an uncommon tumor in the Israeli population. With early diagnosis and aggressive surgical therapy, long-term prognosis is excellent.
authors.affiliation: Pulmonology Institute, Rabin Medical Center, Beilinson Campus, Petah Tiqva.
authors.forename: G
authors.initials: G
authors.lastname: Fink
authors.forename: T
authors.initials: T
authors.lastname: Krelbaum
authors.forename: A
authors.initials: A
authors.lastname: Yellin
authors.forename: D
authors.initials: D
authors.lastname: Bendayan
authors.forename: M
authors.initials: M
authors.lastname: Saute
authors.forename: M
authors.initials: M
authors.lastname: Glazer
authors.forename: M R
authors.initials: MR
authors.lastname: Kramer
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002276:Carcinoid Tumor / Q000175:diagnosis / Q000453:epidemiology / Q000401:mortality / Q000628:therapy; D002648:Child; D005260:Female; D006801:Humans; D007557:Israel / Q000453:epidemiology; D008175:Lung Neoplasms / Q000175:diagnosis / Q000453:epidemiology / Q000401:mortality / Q000628:therapy; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012189:Retrospective Studies; D012907:Smoking / Q000009:adverse effects; D015996:Survival Rate; D016896:Treatment Outcome