Primary Pulmonary Carcinoid Tumor: A Long-term Single Institution Experience.
OBJECTIVE
Primary carcinoid tumors of the lung are rare tumors which comprise approximately 0.5% to 5% of all lung malignancies in adults and roughly 20% to 30% of all carcinoid tumors. The purpose of this retrospective, descriptive study was to describe the incidence, characteristics, and outcomes of patients treated for primary pulmonary carcinoid tumor at a single institution.


METHODS
All patients with a diagnosis of primary pulmonary carcinoid tumor treated from 1989 to 2009 were reviewed. Data collected included demographics, pathology, tobacco use, clinical presentation, tumor location, tumor spread, treatment, and survival.


RESULTS
There were 59 cases of pulmonary carcinoid tumors: 47 typical (80%) and 12 atypical (20%). All but 4 patients underwent surgery, including 54 (92%) lung-sparing resections and 1 pneumonectomy. Five of 55 patients received concurrent adjuvant chemoradiation therapy; 4 patients with atypical and 1 with typical histology. Three additional patients with atypical carcinoid were treated only with adjuvant radiotherapy, palliative radiotherapy, or palliative chemotherapy, respectively. The Kaplan-Meier 5- and 10-year overall survivals were both 80% within the entire population. In the 88% of patients who achieved complete remission, disease-free survival was 98%. A review of a large series from the literature is also presented.


CONCLUSIONS
Surgical resection was primary and adequate therapy for most typical carcinoid tumors with high overall survival and disease-free survival. Adjuvant chemotherapy or radiotherapy might be considered for patients with atypical carcinoid tumors who present with adverse pathologic findings.
University of Utah School of Medicine.
Ryan F
RF
Herde
Department of Radiation Oncology, Huntsman Cancer Hospital.
Kristine E
KE
Kokeny
Department of Internal Medicine, Division of Pulmonary Medicine.
Chakravarthy B
CB
Reddy
Department of Internal Medicine, Division of Oncology.
Wallace L
WL
Akerley
Department of Internal Medicine, Division of Epidemiology, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT.
Nan
N
Hu
Department of Internal Medicine, Division of Pulmonary Medicine.
Jonathan P
JP
Boltax
Department of Radiation Oncology, Huntsman Cancer Hospital.
Ying J
YJ
Hitchcock
D000046:Academic Medical Centers; D000328:Adult; D002276:Carcinoid Tumor / Q000401:mortality* / Q000473:pathology / Q000628:therapy*; D017024:Chemotherapy, Adjuvant; D015331:Cohort Studies; D003131:Combined Modality Therapy; D016208:Databases, Factual; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008175:Lung Neoplasms / Q000401:mortality* / Q000473:pathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness / Q000473:pathology; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000473:pathology; D009367:Neoplasm Staging; D011013:Pneumonectomy / Q000379:methods; D011379:Prognosis; D016016:Proportional Hazards Models; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome; D014589:Utah; D055815:Young Adult