title: Bronchial carcinoid tumors: nodal status and long-term survival after resection.
abstract: BACKGROUND
  Bronchial carcinoid tumors show a favorable outcome. We sought to determinate the variables influencing the long-term survival of patients treated for bronchial carcinoid tumors.
  
  
  METHODS
  We conducted a retrospective single institutional review of 163 patients surgically treated from January 1990 to April 2002. According to 1999 World Health Organization criteria, cases were segregated into typical (<2 mitoses per 2 mm, no necrosis) and atypical carcinoids (2 to 10 mitoses per 2 mm or necrosis).
  
  
  RESULTS
  There were 86 men and 77 women with a mean age of 49.5 +/- 11 years. Symptoms were present in 89 patients (54.6%). Operations included 145 formal lung resections (89%), 9 wedge resections (5.52%), 8 sleeve lobectomies (4.9%), and 1 segmental resection (0.61%) plus radical mediastinal lymphadenectomy in all cases. No operative mortality was reported. Histologic examination showed 121 (74.2%) typical carcinoids (107 N0 and 14 N1), and 42 (25.8%) atypical carcinoids (15 N0, 18 N1, 9 N2). All patients were included in a follow-up (median, 54 months; mean, 58 months; range, 4 to 150 months), which included total body computed tomographic scan and bronchoscopy every year. Overall 5-year survival was 90.3% with a mean survival time of 139 months (95% confidence interval, 133 to 145). In N0 patients with either typical or atypical carcinoid tumors, no disease-related mortality was reported (100% 5-year survival). In N1 patients, 5-year survival was 90.0% for those with typical carcinoids, and 78.8% for those with atypical carcinoids (p = 0.394). In atypical carcinoids with N2 disease, 5-year survival was 22.2%.
  
  
  CONCLUSIONS
  Prognosis in bronchial carcinoid tumors is more related to nodal status than to histologic subtype. In N0 and N1 patients no statistical significant difference has been found between typical and atypical subtype. However, N2 bronchial carcinoid tumors show a dismal prognosis.
authors.affiliation: Thoracic Surgery Unit, Carlo Forlanini Hospital, Azienda Ospedaliera San Camillo-Forlanini, Rome, Italy. gcardillo@scamilloforlanini.rm.it
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Cardillo
authors.forename: Francesco
authors.initials: F
authors.lastname: Sera
authors.forename: Marco
authors.initials: M
authors.lastname: Di Martino
authors.forename: Paolo
authors.initials: P
authors.lastname: Graziano
authors.forename: Roberto
authors.initials: R
authors.lastname: Giunti
authors.forename: Luigi
authors.initials: L
authors.lastname: Carbone
authors.forename: Francesco
authors.initials: F
authors.lastname: Facciolo
authors.forename: Massimo
authors.initials: M
authors.lastname: Martelli
mesh_terms: D000293:Adolescent; D000328:Adult; D001984:Bronchial Neoplasms / Q000401:mortality* / Q000473:pathology* / Q000601:surgery; D002276:Carcinoid Tumor / Q000401:mortality* / Q000473:pathology* / Q000601:surgery; D005260:Female; D006801:Humans; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D008297:Male; D008482:Mediastinum / Q000473:pathology / Q000601:surgery; D008875:Middle Aged; D011379:Prognosis