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DOI: 10.4103/2278-330X.202568
Surgical management of bronchopulmonary carcinoids: A single center experience
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Abstract
Introduction: Bronchopulmonary carcinoids are uncommon tumors with relatively indolent biological behavior but a distinct malignant potential. Surgery is the mainstay of treatment. Our aim was to study preoperative characteristics, surgical approaches, and outcome in patients with bronchopulmonary carcinoid tumors. Patients and Methods: This retrospective study was done in the Department of Surgical Oncology of a Tertiary Teaching Hospital of North India. The case records of all the patients who underwent surgical treatment for lung neoplasms and were diagnosed to have bronchopulmonary carcinoids were reviewed. Details concerning the clinical presentation, preoperative therapy, operative procedure, postoperative complications, and outcome were retrieved from the case records. Results: Sixteen patients who underwent surgical treatment were found to have bronchopulmonary carcinoids on histopathological examination. The median age of the patients was 34 years (range 18–62 years). There were 11 men and five women. All patients were symptomatic, and the median duration of symptoms was 12 months (range 6–72 months) before presentation. Six patients had received antitubercular treatment before presentation, and one patient had been treated with chemotherapy due to misdiagnosis. Surgical procedures included six pneumonectomies (one with carinoplasty), four bilobectomies, three lobectomies, and three bronchoplastic procedures (two with lobectomy and one with bilobectomy). There was no postoperative mortality; three patients had morbidity in the form of lobar collapse, prolonged pleural collection, and surgical site infection. With a median follow-up time of 11 months (range 2–85 months), all the 16 patients are alive and disease-free. Conclusions: Delayed presentation and misdiagnosis of bronchial carcinoid are major concerns in North India. Adequate surgical resection can be performed without undue morbidity and is associated with good long-term results.
Publication History
Article published online:
22 December 2020
© 2017. MedIntel Services Pvt Ltd. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/.)
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References
- 1 Gustafsson BI, Kidd M, Chan A, Malfertheiner MV, Modlin IM. Bronchopulmonary neuroendocrine tumors. Cancer 2008;113:5-21.
- 2 Fink G, Krelbaum T, Yellin A, Bendayan D, Saute M, Glazer M, et al. Pulmonary carcinoid: Presentation, diagnosis, and outcome in 142 cases in Israel and review of 640 cases from the literature. Chest. 2001;119:1647-51.
- 3 Travis WD, Giroux DJ, Chansky K, Crowley J, Asamura H, Brambilla E, et al. The IASLC lung cancer staging project: Proposals for the inclusion of broncho-pulmonary carcinoid tumors in the forthcoming (seventh) edition of the TNM classification for lung cancer. J Thorac Oncol 2008;3:1213-23.
- 4 Yao JC, Hassan M, Phan A, Dagohoy C, Leary C, Mares JE, et al. One hundred years after “carcinoid”: Epidemiology of and prognostic factors for neuroendocrine tumors in 35,825 cases in the United States. J Clin Oncol 2008;26:3063-72.
- 5 Skuladottir H, Hirsch FR, Hansen HH, Olsen JH. Pulmonary neuroendocrine tumors: Incidence and prognosis of histological subtypes. A population-based study in Denmark. Lung Cancer 2002;37:127-35.
- 6 Öberg K, Hellman P, Ferolla P, Papotti M; ESMO Guidelines Working Group. Neuroendocrine bronchial and thymic tumors: ESMO clinical practice guidelines for diagnosis, treatment and follow-up. Ann Oncol 2012;23 Suppl 7:vii120-3.
- 7 Travis WD, Rush W, Flieder DB, Falk R, Fleming MV, Gal AA, et al. Survival analysis of 200 pulmonary neuroendocrine tumors with clarification of criteria for atypical carcinoid and its separation from typical carcinoid. Am J Surg Pathol 1998;22:934-44.
- 8 Edge S, Byrd DR, Compton CC, Fritz AG, Greene FL, Trotti A. American Joint Committee on Cancer Staging Manual. 7th ed. New York: Springer; 2010. p. 253.
- 9 Fink G, Krelbaum T, Yellin A, Bendayan D, Saute M, Glazer M, et al. Pulmonary carcinoid: Presentation, diagnosis, and outcome in 142 cases in Israel and review of 640 cases from the literature. Chest 2001;119:1647-51.
- 10 Rekhtman N. Neuroendocrine tumors of the lung: An update. Arch Pathol Lab Med 2010;134:1628-38.
- 11 Thomas R, Christopher DJ, Balamugesh T, Shah A. Clinico-pathologic study of pulmonary carcinoid tumours – A retrospective analysis and review of literature. Respir Med 2008;102:1611-4.
- 12 Aron M, Kapila K, Verma K. Carcinoid tumors of the lung: A diagnostic challenge in bronchial washings. Diagn Cytopathol 2004;30:62-6.
- 13 Cardillo G, Sera F, Di Martino M, Graziano P, Giunti R, Carbone L, et al. Bronchial carcinoid tumors: Nodal status and long-term survival after resection. Ann Thorac Surg 2004;77:1781-5.
- 14 Venkitaraman B, Karunanithi S, Kumar A, Khilnani GC, Kumar R. Role of 68Ga-DOTATOC PET/CT in initial evaluation of patients with suspected bronchopulmonary carcinoid. Eur J Nucl Med Mol Imaging 2014;41:856-64.
- 15 Ferolla P, Daddi N, Urbani M, Semeraro A, Ribacchi R, Giovenali P, et al. Tumorlets, multicentric carcinoids, lymph-nodal metastases, and long-term behavior in bronchial carcinoids. J Thorac Oncol 2009;4:383-7.
- 16 Daddi N, Ferolla P, Urbani M, Semeraro A, Avenia N, Ribacchi R, et al. Surgical treatment of neuroendocrine tumors of the lung. Eur J Cardiothorac Surg 2004;26:813-7.
- 17 El Jamal M, Nicholson AG, Goldstraw P. The feasibility of conservative resection for carcinoid tumours: Is pneumonectomy ever necessary for uncomplicated cases? Eur J Cardiothorac Surg 2000;18:301-6.
- 18 Pandey D, Ramanathan P, Khurse BB, Bharati SJ, Mishra S. Bronchoscopic debulking followed by bronchoplastic procedure helps in limiting lung resection in a bronchial carcinoid: A case report. Indian J Surg Oncol 2014;5:214-6.
- 19 Phan AT, Oberg K, Choi J, Harrison LH Jr., Hassan MM, Strosberg JR, et al. NANETS consensus guideline for the diagnosis and management of neuroendocrine tumors: Well-differentiated neuroendocrine tumors of the thorax (includes lung and thymus). Pancreas 2010;39:784-98.
- 20 National Comprehensive Cancer Network (NCCN). Clinical Practice Guidelines in Oncology. Available from: http://www.nccn.org/professionals/physician_gls/f_guidelines.asp. [Last accessed on 2014 Mar 10].