title: Surgical treatment of bronchial carcinoid tumors: a single-center experience.
abstract: 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.
authors.affiliation: Division of Thoracic Surgery, Pavilhão Pereira Filho, Santa Casa de Porto Alegre, Brazil. machuca36@hotmail.com
authors.forename: Tiago Noguchi
authors.initials: TN
authors.lastname: Machuca
authors.forename: Paulo Francisco Guerreiro
authors.initials: PF
authors.lastname: Cardoso
authors.forename: Spencer Marcantonio
authors.initials: SM
authors.lastname: Camargo
authors.forename: Leonardo
authors.initials: L
authors.lastname: Signori
authors.forename: Cristiano Feijó
authors.initials: CF
authors.lastname: Andrade
authors.forename: Ana Luiza Schneider
authors.initials: AL
authors.lastname: Moreira
authors.forename: José da Silva
authors.initials: Jda S
authors.lastname: Moreira
authors.forename: José Carlos
authors.initials: JC
authors.lastname: Felicetti
authors.forename: José Jesus
authors.initials: JJ
authors.lastname: Camargo
mesh_terms: 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