OBJECTIVE: To evaluate type of surgery, long-term survival and factors influencing outcome in pulmonary carcinoid tumors. PATIENTS AND METHODS: We reviewed data of 252 patients who underwent surgery for carcinoid tumor in 1968-1989 (Group A) and in 1990-2005 (Group B). All cases were reviewed and classified as typical (TC) or atypical carcinoid (AC) according to WHO criteria (1999). RESULTS: There were 174 (69%) patients with TC (167 N0, 6 N1 and 1 N2) and 78 (31%) with AC (56 N0, 13 N1, 9 N2). Surgery consisted of 163 (64.7%) formal lung resections (121 lobectomies, 18 bilobectomies, 14 segmentectomies, 10 pneumonectomies), 76 (30.1%) sleeve or bronchoplastic resections and 13 (5.2%) wedge resections. No perioperative mortality occurred, 17 (6.7%) patients experienced complications. Overall 5, 10 and 15-year survival rate was 90%, 83% and 77%. TC showed a more favourable prognosis than AC (10-year survival rate 93% and 64%; p=0.00001) as well as N0 patients in comparison with N1-2 patients (10-year survival rate 87% and 50%; p=0.00005). Group A received lymph-node sampling, Group B received a systematic lymphadenectomy. No difference was found between Group A and B in detection of nodal metastases (10.9% versus 11.9%; p=0.79), but in Group A we observed 2 lymph-node relapses. In Group B number of sleeve resections significantly increased (2.7% versus 20.4%; p=0.0001) and number of pneumonectomies showed a significant reduction (7.2% versus 1.4%; p=0.01). CONCLUSIONS: Typical histology and N0 status were important prognostic factors in carcinoid tumors. Parenchyma-sparing procedures must be considered the treatment of choice with systematic lymphadenectomy.
OBJECTIVE: To evaluate type of surgery, long-term survival and factors influencing outcome in pulmonary carcinoid tumors. PATIENTS AND METHODS: We reviewed data of 252 patients who underwent surgery for carcinoid tumor in 1968-1989 (Group A) and in 1990-2005 (Group B). All cases were reviewed and classified as typical (TC) or atypical carcinoid (AC) according to WHO criteria (1999). RESULTS: There were 174 (69%) patients with TC (167 N0, 6 N1 and 1 N2) and 78 (31%) with AC (56 N0, 13 N1, 9 N2). Surgery consisted of 163 (64.7%) formal lung resections (121 lobectomies, 18 bilobectomies, 14 segmentectomies, 10 pneumonectomies), 76 (30.1%) sleeve or bronchoplastic resections and 13 (5.2%) wedge resections. No perioperative mortality occurred, 17 (6.7%) patients experienced complications. Overall 5, 10 and 15-year survival rate was 90%, 83% and 77%. TC showed a more favourable prognosis than AC (10-year survival rate 93% and 64%; p=0.00001) as well as N0 patients in comparison with N1-2 patients (10-year survival rate 87% and 50%; p=0.00005). Group A received lymph-node sampling, Group B received a systematic lymphadenectomy. No difference was found between Group A and B in detection of nodal metastases (10.9% versus 11.9%; p=0.79), but in Group A we observed 2 lymph-node relapses. In Group B number of sleeve resections significantly increased (2.7% versus 20.4%; p=0.0001) and number of pneumonectomies showed a significant reduction (7.2% versus 1.4%; p=0.01). CONCLUSIONS: Typical histology and N0 status were important prognostic factors in carcinoid tumors. Parenchyma-sparing procedures must be considered the treatment of choice with systematic lymphadenectomy.
Authors: Ellen M B P Reuling; Chris Dickhoff; Peter W Plaisier; Veerle M H Coupé; Albert H A Mazairac; Rutger J Lely; H Jaap Bonjer; Johannes M A Daniels Journal: Respiration Date: 2018-02-12 Impact factor: 3.580
Authors: L Bodei; D Ferone; C M Grana; M Cremonesi; A Signore; R A Dierckx; G Paganelli Journal: J Endocrinol Invest Date: 2009-04 Impact factor: 4.256
Authors: Patrick M Forde; Craig M Hooker; Sosipatros A Boikos; Iacope Petrini; Giuseppe Giaccone; Charles M Rudin; Stephen C Yang; Peter B Illei; Christine L Hann; David S Ettinger; Julie R Brahmer; Ronan J Kelly Journal: J Thorac Oncol Date: 2014-03 Impact factor: 15.609
Authors: Robert A Ramirez; David T Beyer; Anne E Diebold; Brianne A Voros; Maria M Chester; Yi-Zarn Wang; J Philip Boudreaux; Eugene A Woltering; Ann-Porter Uhlhorn; Pamela Ryan; Richard J Campeau; Lowell B Anthony Journal: Ochsner J Date: 2017