Bronchial carcinoid tumors: surgical management and long-term outcome.
OBJECTIVE
We sought to determine the variables influencing long-term survival of patients treated for bronchial carcinoid tumors.


METHODS
A retrospective, mono-institutional review of patients subjected to surgical treatment since 1977 was conducted.


RESULTS
Over 22 years, 126 patients with a final histologic diagnosis of bronchial carcinoid tumors were assessed for surgery. The group comprised 72 men (57%) and 54 women (43%) with a mean age at presentation of 47 +/- 16 years (range 11-77 years). Symptoms were present in 65 (53%) patients. Operations included lobectomy or bilobectomy in 88 (with 4 bronchoplastic procedures), pneumonectomy in 15, segmentectomy in 3, wedge resection in 16, and bronchial sleeve resection in 3 patients. One patient (0.7%) died in the perioperative period. Eighty-two patients (65%) had typical and 44 (35%) had atypical carcinoid tumors. Postoperative staging was complete for 113 of 126 patients (13 patients did not undergo lymphadenectomy): 90 patients had stage I disease, 6 had stage II, 15 had stage III, and 2 had stage IV disease. A typical subtype was stage I in 70 and more advanced (II-IV) in 5, whereas an atypical subtype was stage I in 20 and more advanced in 18 (P <.05). Mean follow-up was 99 +/- 73 months (range 6-282 months) during which 19 (15%) patients died (12 of recurrent disease). Recurrent tumor developed in 4 (5.5%) of 72 patients affected by typical subtypes and 8 (19.5%) of 41 by atypical subtypes with complete follow-up. Overall survival at 15 years was 74%; survival related to histologic type and nodal status at 15 years was significant (P <.05).


CONCLUSIONS
Biologic behavior and prognosis for bronchial carcinoid tumors are better than for other lung cancers. Surgical treatment requires radical excision and lymph node sampling. Survival and long-term outcome are significantly related to the histologic type, nodal status, and pathologic stage.
Filosso
Pier Luigi
PL
Department of Thoracic Surgery, University of Torino, San Giovanni Battista Hospital, Torino, Italy. pierluigifilosso@tiscalinet.it
Rena
Ottavio
O
Donati
Giovanni
G
Casadio
Caterina
C
Ruffini
Enrico
E
Papalia
Esther
E
Oliaro
Alberto
A
Maggi
Giuliano
G
D001706:Biopsy; D001984:Bronchial Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D002276:Carcinoid Tumor / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008168:Lung / Q000473:pathology; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011013:Pneumonectomy; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate; D013997:Time Factors