Stefani A, Morandi U, Urgese A L, Rivasi F, Lodi R
Department of Cardio-Thoracic Surgery, University of Modena, Italy.
J Cardiovasc Surg (Torino). 1999 Aug;40(4):607-12.
The aim of this study was to analyse two groups of patients operated for bronchopulmonary neuroendocrine neoplasms (bronchial carcinoid and well-differentiated neuroendocrine carcinoma) and to investigate their clinico-pathological data and long-term survival.
From January 1978 to June 1996, 65 patients with bronchial carcinoids underwent operation at our Institution. There were 33 males and 32 females, whose mean age was 49.8 years. Forty-four neoplasms (67.7%) were considered to be central. Histology revealed 54 typical bronchial carcinoids (83%) and 11 well-differentiated neuroendocrine carcinomas (17%). Surgical resection of tumor and complete lymph node dissection was performed in all cases.
All patients entered follow-up: 5-year survival was 91% for patients with bronchial carcinoid and 49% for those with well-differentiated neuroendocrine carcinoma (p<0.05). Univariate analysis found that there was a significant decrease in survival also for peripheral location of the tumor, advanced pathologic stage and histologically positive lymph nodes.
These results point out that carcinoid tumors are malignant neoplasms, so they require a complete and radical surgical resection. Most tumors are only locally invasive and show a low aggressive behaviour; therefore, when possible, it is recommended to attempt a limited resection. Frozen sections of bronchial margins and complete lymphadenectomy should be routinely performed. The same criteria should apply to well differentiated neuroendocrine carcinomas, though their behaviour is more aggressive.
