N Motas1,2, C Motas1,2, M Davidescu1,2, D Achim1, O Rus1, E Jianu1, T Horvat1,2. 1. "Prof. Dr. Al. Trestioreanu" Institute of Oncology, Clinic of Thoracic Surgery, Bucharest, Romania. 2. "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania.
Abstract
CONTEXT: Management of neuroendocrine tumors is highly dynamic, in both diagnosis and treatment. OBJECTIVE: Surgical resection with lymph node approach offers excellent 5-years survival. DESIGN: Between 2008 and 2011 we operated with radical intent 326 lung cancers. PATIENTS AND METHODS: Cases without lymph node approach were excluded. We found 38 neuroendocrine malignancies: 12 typical carcinoids, 3 atypical carcinoids, 4 large cell neuroendocrine carcinomas (LCNEC) and 10 small-cell lung cancers (SCLC). Limits of the study are: variable lymphadenectomy technique; absence of PET - CT and EBUS-TBNA (EndoBronchial UltraSound - TransBronchial Needle Aspiration) for staging; incomplete data for disease-free survival. RESULTS: We performed 13 pneumonectomies, 22 lobectomies and 3 non-anatomical resections. There were 5 bronchoplasties. The 5-year survival difference between NSCLC (non-small-cell lung cancer - 42.9%) and SCLC (40.53% - one of the best from the literature) is not statistically significant (p=0.4780). Five-years survival was 100% for typical and atypical carcinoids - the best published. We found lymph node metastasis in 2 typical carcinoids, in 2 atypical carcinoids and in 6 SCLCs. CONCLUSIONS: For typical and atypical carcinoids, radical resection with lymphadenectomy offers 100% 5-years survival. Early-stage SCLC may benefit from radical resection; lymph node dissection is mandatory because of the well-known precocious lymphatic dissemination.
CONTEXT: Management of neuroendocrine tumors is highly dynamic, in both diagnosis and treatment. OBJECTIVE: Surgical resection with lymph node approach offers excellent 5-years survival. DESIGN: Between 2008 and 2011 we operated with radical intent 326 lung cancers. PATIENTS AND METHODS: Cases without lymph node approach were excluded. We found 38 neuroendocrine malignancies: 12 typical carcinoids, 3 atypical carcinoids, 4 large cell neuroendocrine carcinomas (LCNEC) and 10 small-cell lung cancers (SCLC). Limits of the study are: variable lymphadenectomy technique; absence of PET - CT and EBUS-TBNA (EndoBronchial UltraSound - TransBronchial Needle Aspiration) for staging; incomplete data for disease-free survival. RESULTS: We performed 13 pneumonectomies, 22 lobectomies and 3 non-anatomical resections. There were 5 bronchoplasties. The 5-year survival difference between NSCLC (non-small-cell lung cancer - 42.9%) and SCLC (40.53% - one of the best from the literature) is not statistically significant (p=0.4780). Five-years survival was 100% for typical and atypical carcinoids - the best published. We found lymph node metastasis in 2 typical carcinoids, in 2 atypical carcinoids and in 6 SCLCs. CONCLUSIONS: For typical and atypical carcinoids, radical resection with lymphadenectomy offers 100% 5-years survival. Early-stage SCLC may benefit from radical resection; lymph node dissection is mandatory because of the well-known precocious lymphatic dissemination.
Authors: William D Travis; Elisabeth Brambilla; Andrew G Nicholson; Yasushi Yatabe; John H M Austin; Mary Beth Beasley; Lucian R Chirieac; Sanja Dacic; Edwina Duhig; Douglas B Flieder; Kim Geisinger; Fred R Hirsch; Yuichi Ishikawa; Keith M Kerr; Masayuki Noguchi; Giuseppe Pelosi; Charles A Powell; Ming Sound Tsao; Ignacio Wistuba Journal: J Thorac Oncol Date: 2015-09 Impact factor: 15.609
Authors: Malcolm V Brock; Craig M Hooker; James E Syphard; William Westra; Li Xu; Anthony J Alberg; David Mason; Stephen B Baylin; James G Herman; Rex C Yung; Julie Brahmer; Charles M Rudin; David S Ettinger; Stephen C Yang Journal: J Thorac Cardiovasc Surg Date: 2005-01 Impact factor: 5.209
Authors: Vidhan Chandra; Mark S Allen; Francis C Nichols; Claude Deschamps; Stephen D Cassivi; Peter C Pairolero Journal: Mayo Clin Proc Date: 2006-05 Impact factor: 7.616
Authors: W D Travis; R I Linnoila; M G Tsokos; C L Hitchcock; G B Cutler; L Nieman; G Chrousos; H Pass; J Doppman Journal: Am J Surg Pathol Date: 1991-06 Impact factor: 6.394
Authors: Eric Vallières; Frances A Shepherd; John Crowley; Paul Van Houtte; Pieter E Postmus; Desmond Carney; Kari Chansky; Zeba Shaikh; Peter Goldstraw Journal: J Thorac Oncol Date: 2009-09 Impact factor: 15.609
Authors: Margreet Lüchtenborg; Sharma P Riaz; Eric Lim; Richard Page; David R Baldwin; Erik Jakobsen; Peter Vedsted; Mike Lind; Michael D Peake; Anders Mellemgaard; James Spicer; Loic Lang-Lazdunski; Henrik Møller Journal: Thorax Date: 2013-10-30 Impact factor: 9.139