Thorac Cardiovasc Surg 2005; 53(3): 168-172
DOI: 10.1055/s-2005-837539
Original Thoracic

© Georg Thieme Verlag KG Stuttgart · New York

Carcinoid Tumors of the Lung and Multimodal Therapy

D. Divisi1 , R. Crisci1
  • 1Department of Thoracic Surgery, University of L'Aquila, “G. Mazzini” Hospital, Teramo, Italy
Further Information

Publication History

Received November 4, 2004

Publication Date:
30 May 2005 (online)

Abstract

Aim: To report our experience with bronchial carcinoids. Methods: From January 1990 to March 2003 we treated 42 such patients, 30 females and 12 males. All patients underwent preoperative total body computed tomography (CT), total body In-111 octreotide scintigraphy, and SPECT of the thorax, with evaluation of serum levels of CEA, CgA, NSE, and urinary 5-HIAA. Diagnosis was obtained in 28 patients with fibre-optic bronchoscopy and in 14 patients with CT-guided trans-thoracic needle biopsy. Results: There were 26 typical and 16 atypical carcinoids. 30 lobectomies, 5 bilobectomies, 6 wedge resections, and 1 pneumonectomy were carried out. The 3-year and the 5-year survival rates in the typical and atypical carcinoid groups were 100 % and 96 % vs. 81 % and 68 %, respectively (p < 0.001). Conclusions: Long-term survival is based on histological completeness of surgical treatment. Octreotide scintigraphy and SPECT document N1 and N2 precisely.

References

  • 1 Pearse A G. The APUD cell concept and its implication in pathology.  Pathol Annu. 1974;  9 27-41
  • 2 Arrigoni M G, Woolner L B, Bernatz P E. Atypical carcinoid tumors of the lung.  J Thorac Cardiovasc Surg. 1972;  64 413-421
  • 3 Paladugu R R, Benfield J R, Pak H Y, Ross R K, Teplitz R L. Bronchopulmonary Kulchitzky cell carcinomas. A new classification scheme for typical and atypical carcinoids.  Cancer. 1985;  55 1303-1311
  • 4 Dresler C M, Ritter J H, Patterson G A, Ross E, Bailey M S, Wick M R. Clinical pathologic analysis of 40 patients with large cell neuroendocrine carcinoma of the lung.  Ann Thorac Surg. 1997;  63 180-185
  • 5 Travis W D, Colby T V, Corrin B, Shimosato Y, Brambilla E, Sobin L H. et al .WHO International Histological Classification of Tumours. Heidelberg; Springer Verlag 1999
  • 6 Mountain C F. Revisions in the international system for staging lung cancer.  Chest. 1997;  111 1710-1717
  • 7 Joensuu H, Katka K, Kujari H. Dramatic response of a metastic carcinoid tumor to a combination of interferon and octreotide.  Acta Endocrinol. 1992;  126 184-185
  • 8 Vadasz P, Palffy G, Egervary M, Schaff Z. Diagnosis and treatment of bronchial carcinoid tumors: clinical and pathological review of 120 operated patients.  Eur J Cardiothorac Surg. 1993;  7 8-11
  • 9 Marty-Ané C H, Costes V, Pujol J L, Alauzen M, Baldet P, Mary H. Carcinoid tumors of the lung: do atypical features require aggressive management?.  Ann Thorac Surg. 1995;  59 78-83
  • 10 Paulson D R, Ginsberg R J. Bronchial adenoma. Shields TW General Thoracic Surgery. Philadelphia; Lea & Febiger 1983: 712-728
  • 11 Rea F, Binda R, Spreafico G, Calabrò F, Bonavina L, Cipriani A, Di Vittorio G, Fassina A, Sartori F. Bronchial carcinoids: a review of 60 patients.  Ann Thorac Surg. 1989;  47 412-414
  • 12 Schepens M A, Van Schil P E, Knaepen P J, Van Swieten H A, Brutel de la Rivière A. Late results of sleeve resection for typical bronchial carcinoids.  Eur J Cardio-thorac Surg. 1994;  8 118-121
  • 13 Solaini L, Bagioni P, Prusciano F, Di Francesco F, Poddie D B. Video-assisted thoracic surgery (VATS) lobectomy for typical bronchopulmonary carcinoid tumors.  Surg Endosc. 2000;  14 1142-1145
  • 14 Okike N, Bernatz P E, Payne W S, Woolner L B, Leonard P F. Bronchoplastic procedures in the treatment of carcinoid tumors of the tracheobronchial tree.  J Thorac Cardiovasc Surg. 1978;  76 281-291
  • 15 Granberg D, Eriksson B, Wilander E, Grimfjard P, Fjallskog M L, Oberg Skogseid B. Experience in treatment of metastatic pulmonary carcinoid tumors.  Ann Oncol. 2001;  12 1383-1391
  • 16 Cooper W A, Thourani V H, Gal A A, Lee R B, Mansour K A, Miller J I. The surgical spectrum of pulmonary neuroendocrine neoplasms.  Chest. 2001;  119 14-18
  • 17 Thomas Jr C F, Tazelaar H D, Jett J R. Typical and atypical pulmonary carcinoids: outcome in patients presenting with regional lymph node involvement.  Chest. 2001;  119 1143-1150
  • 18 Ferguson M K, Landreneau R J, Hazelrigg S R, Altorki N K, Naunheim K S, Zwischenberger J B, Kent M, Yim A P. Long-term outcome after resection for bronchial carcinoid tumors.  Eur J Cardio-thorac Surg. 2000;  18 156-161
  • 19 Hage R, de la Rivière A B, Seldenrijk C A, van den Bosch J M. Update in pulmonary carcinoid tumors: a review article.  Ann Surg Oncol. 2003;  10 697-704

Dr. D. Divisi

Department of Thoracic Surgery, University of L'Aquila, “G. Mazzini” Hospital

Circonvallazione Ragusa 39

64100 Teramo

Italy

Phone: + 39861429482

Fax: + 39 8 61 21 16 26

Email: duilio.divisi@virgilio.it