Chen Fengshi, Sato Toshihiko, Fujinaga Takuji, Sakai Hiroaki, Miyahara Ryo, Bando Toru, Date Hiroshi
Department of Thoracic Surgery, Kyoto University, 54 Shogoin-Kawahara-cho, Sakyo-ku, Kyoto 606-8507, Japan.
Interact Cardiovasc Thorac Surg. 2010 Dec;11(6):737-9. doi: 10.1510/icvts.2010.247361. Epub 2010 Sep 19.
Bronchopulmonary typical carcinoid tumors are well known as low-grade malignant tumors with fairly benign behaviors; however, distant metastasis after complete resection and multiple carcinoid tumors in the resected lungs have been sporadically reported. Lesser resections are preferred including lung-sparing surgery, while the importance of major surgical resections is also emphasized. For better understanding of bronchopulmonary typical carcinoid tumors, we reviewed our institutional experience. Eight patients with bronchopulmonary typical carcinoid tumors underwent complete pulmonary resection. Various perioperative variables and postoperative survival were investigated retrospectively. All patients were alive after surgery. Seven patients received more than a lobectomy and one underwent a segmentectomy for a peripheral small nodule. In all patients, systemic nodal dissection was performed. In one patient who received a lobectomy for a peripheral nodule, multiple carcinoid tumors were found in the resected specimen. No patients received any adjuvant chemotherapy or radiotherapy after pulmonary resection. In one patient, tumors recurred at the bronchial stump and in the liver approximately five years after complete pulmonary resection. Despite a small number of cases, our study supported the idea that bronchopulmonary typical carcinoid tumors might require major surgical procedures and that complete pulmonary resection of typical carcinoid tumors could expect long-term survival.
支气管肺典型类癌瘤是众所周知的具有相当良性行为的低度恶性肿瘤;然而,已偶有关于完全切除后远处转移以及切除肺内出现多个类癌瘤的报道。较小范围的切除手术更受青睐,包括保留肺组织的手术,不过也强调了大手术切除的重要性。为了更好地了解支气管肺典型类癌瘤,我们回顾了我们机构的经验。8例支气管肺典型类癌瘤患者接受了全肺切除。对各种围手术期变量和术后生存率进行了回顾性研究。所有患者术后均存活。7例患者接受了超过肺叶切除,1例因外周小结节接受了肺段切除。所有患者均进行了系统性淋巴结清扫。在1例因外周结节接受肺叶切除的患者中,切除标本中发现多个类癌瘤。肺切除术后,没有患者接受任何辅助化疗或放疗。1例患者在全肺切除术后约5年,肿瘤在支气管残端和肝脏复发。尽管病例数量较少,但我们的研究支持这样的观点,即支气管肺典型类癌瘤可能需要大手术,并且典型类癌瘤的全肺切除有望获得长期生存。