Surgical treatment of bronchial carcinoid tumors: a single-center experience.
BACKGROUND
Bronchial carcinoid is an infrequent neoplasm with a neuroendocrine differentiation. Surgical treatment is the gold standard therapy, with procedures varying from sublobar resections to complex lung sparing broncoplastic procedures. This study evaluates the results of surgical treatment of bronchial carcinoids and its prognostic factors.


METHODS
Retrospective review of 126 consecutive patients who underwent surgical treatment for bronchial carcinoid tumors between December 1974 and July 2007.


RESULTS
There were 70 females (55%) and the mean age was 46 years, ranging from 17 to 81 years. Upon clinical presentation, 38 patients (30%) have had recurrent respiratory tract infection, 31 (24%) cough, 16 (12%) chest pain and 25 (20%) were asymptomatic. Preoperative bronchoscopic diagnosis was obtained in 74 cases (58.7%). The procedures performed were: 19 sublobar resections (14,9%), 58 lobectomies (46%), 8 bilobectomies (6.3%), 6 pneumonectomies (4.7%), 2 sleeve segmentectomies (1.5%), 26 sleeve lobectomies (20.6%) and 9 bronchoplastic procedures without lung resection (7.1%). Operative mortality was 1.5% (n = 2) and morbidity was 25.8% (n=32), including 12 respiratory tract infections and 4 reinterventions due to bleeding (3) and pleural empyema (1). Among the 112 patients available for follow-up, the overall survival at 3, 5 and 10 years was 89.2%, 85.5% and 79.8%, respectively. Five and 10-year survival for typical and atypical carcinoids were 91, 89% and 56, 47%, respectively. Overall disease-free survival at 5 years was 91.9% Statistical analysis showed that overall disease-free survival correlated with histology--typical vs. atypical--(p = 0.04) and stage (p = 0.02).


CONCLUSIONS
Surgery provides safe and adequate treatment to bronchial carcinoid tumors. Histology and stage were the main prognostic factors.
Machuca
Tiago Noguchi
TN
Division of Thoracic Surgery, Pavilhão Pereira Filho, Santa Casa de Porto Alegre, Brazil. machuca36@hotmail.com
Cardoso
Paulo Francisco Guerreiro
PF
Camargo
Spencer Marcantonio
SM
Signori
Leonardo
L
Andrade
Cristiano Feijó
CF
Moreira
Ana Luiza Schneider
AL
Moreira
José da Silva
Jda S
Felicetti
José Carlos
JC
Camargo
José Jesus
JJ
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001984:Bronchial Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D001999:Bronchoscopy / Q000379:methods / Q000401:mortality; D002276:Carcinoid Tumor / Q000175:diagnosis* / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D005336:Fiber Optic Technology / Q000639:trends; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D012307:Risk Factors; D016019:Survival Analysis; D016896:Treatment Outcome