支气管类癌肿瘤的外科治疗：单中心经验。

Surgical treatment of bronchial carcinoid tumors: a single-center experience.

机构信息

Division of Thoracic Surgery, Pavilhão Pereira Filho, Santa Casa de Porto Alegre, Brazil.

出版信息

Lung Cancer. 2010 Nov;70(2):158-62. doi: 10.1016/j.lungcan.2010.01.015. Epub 2010 Mar 12.

DOI:10.1016/j.lungcan.2010.01.015

PMID:20223552

Abstract

BACKGROUND

Bronchial carcinoid is an infrequent neoplasm with a neuroendocrine differentiation. Surgical treatment is the gold standard therapy, with procedures varying from sublobar resections to complex lung sparing broncoplastic procedures. This study evaluates the results of surgical treatment of bronchial carcinoids and its prognostic factors.

PATIENTS AND METHODS

Retrospective review of 126 consecutive patients who underwent surgical treatment for bronchial carcinoid tumors between December 1974 and July 2007.

RESULTS

There were 70 females (55%) and the mean age was 46 years, ranging from 17 to 81 years. Upon clinical presentation, 38 patients (30%) have had recurrent respiratory tract infection, 31 (24%) cough, 16 (12%) chest pain and 25 (20%) were asymptomatic. Preoperative bronchoscopic diagnosis was obtained in 74 cases (58.7%). The procedures performed were: 19 sublobar resections (14,9%), 58 lobectomies (46%), 8 bilobectomies (6.3%), 6 pneumonectomies (4.7%), 2 sleeve segmentectomies (1.5%), 26 sleeve lobectomies (20.6%) and 9 bronchoplastic procedures without lung resection (7.1%). Operative mortality was 1.5% (n = 2) and morbidity was 25.8% (n=32), including 12 respiratory tract infections and 4 reinterventions due to bleeding (3) and pleural empyema (1). Among the 112 patients available for follow-up, the overall survival at 3, 5 and 10 years was 89.2%, 85.5% and 79.8%, respectively. Five and 10-year survival for typical and atypical carcinoids were 91, 89% and 56, 47%, respectively. Overall disease-free survival at 5 years was 91.9% Statistical analysis showed that overall disease-free survival correlated with histology--typical vs. atypical--(p = 0.04) and stage (p = 0.02).

CONCLUSION

Surgery provides safe and adequate treatment to bronchial carcinoid tumors. Histology and stage were the main prognostic factors.

摘要

背景

支气管类癌是一种罕见的神经内分泌分化肿瘤。手术治疗是金标准疗法，手术方式从肺段切除术到复杂的肺保留支气管成形术不等。本研究评估了支气管类癌的手术治疗结果及其预后因素。

患者与方法

回顾性分析 1974 年 12 月至 2007 年 7 月期间 126 例连续接受支气管类癌肿瘤手术治疗的患者。

结果

女性 70 例（55%），平均年龄 46 岁，年龄 17-81 岁。临床表现为 38 例（30%）反复呼吸道感染，31 例（24%）咳嗽，16 例（12%）胸痛，25 例（20%）无症状。术前支气管镜诊断 74 例（58.7%）。手术方式为：肺段切除术 19 例（14.9%），肺叶切除术 58 例（46%），双肺叶切除术 8 例（6.3%），全肺切除术 6 例（4.7%），袖状段切除术 2 例（1.5%），袖状肺叶切除术 26 例（20.6%），9 例支气管成形术无肺切除术（7.1%）。手术死亡率为 1.5%（n=2），发病率为 25.8%（n=32），包括 12 例呼吸道感染和 4 例因出血（3 例）和脓胸（1 例）再干预。在 112 例可随访的患者中，3、5 和 10 年的总生存率分别为 89.2%、85.5%和 79.8%。典型和非典型类癌的 5 年和 10 年生存率分别为 91%、89%和 56%、47%。5 年无病生存率的统计分析显示，无病生存率与组织学-典型与非典型-相关（p=0.04）和分期（p=0.02）。