title: Bronchial carcinoid tumors: surgical management and long-term outcome.
abstract: 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.
authors.affiliation: Department of Thoracic Surgery, University of Torino, San Giovanni Battista Hospital, Torino, Italy. pierluigifilosso@tiscalinet.it
authors.forename: Pier Luigi
authors.initials: PL
authors.lastname: Filosso
authors.forename: Ottavio
authors.initials: O
authors.lastname: Rena
authors.forename: Giovanni
authors.initials: G
authors.lastname: Donati
authors.forename: Caterina
authors.initials: C
authors.lastname: Casadio
authors.forename: Enrico
authors.initials: E
authors.lastname: Ruffini
authors.forename: Esther
authors.initials: E
authors.lastname: Papalia
authors.forename: Alberto
authors.initials: A
authors.lastname: Oliaro
authors.forename: Giuliano
authors.initials: G
authors.lastname: Maggi
mesh_terms: 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