Ducrocq X, Thomas P, Massard G, Barsotti P, Giudicelli R, Fuentes P, Wihlm J M
Department of Thoracic Surgery, University Hospital of Strasbourg, France.
Ann Thorac Surg. 1998 May;65(5):1410-4. doi: 10.1016/s0003-4975(98)00083-6.
This study estimated operative risk and examined factors determining long-term survival after resection of typical carcinoid tumors.
From 1976 to 1996, 139 consecutive patients (66 male and 73 female patients with a mean age of 47 +/- 15 years) underwent thoracotomy for typical carcinoid tumor. The tumors were centrally located in 102 patients (73.4%).
Radical resection was performed in 106 patients (7 pneumonectomies, 13 bilobectomies, and 86 lobectomies) and conservative resection in 33 (3 segmentectomies, 3 wedge resections, 20 sleeve lobectomies, and 7 sleeve bronchectomies). There were no postoperative deaths. Complications occurred in 19 patients (13.7%). The morbidity rate was not increased after bronchoplastic procedures (chi 2 = 0.033, not significant). Staging was pT1 in 107 patients (77.0%) and pT2 in 32 (23.0%); 13 patients (9.4%) had nodal metastases. Seventeen patients have died (12.2%), during follow-up, but only three deaths were related to the disease. The overall survival rate at 5, 10, and 15 years was estimated to be 92.4%, 88.3%, and 76.4%, respectively; estimated disease-free survival was 100% at 5 years and 91.4% at 10 and 15 years. Estimated survival of patients with lymph node metastasis was 100% at 5, 10, and 15 years. Univariate analysis failed to demonstrate any prognostic significance for sex, tumor size (T1 versus T2), tumor location (central versus peripheral), and type of resection.
These data confirm an excellent prognosis after complete resection of typical carcinoid tumors, including those with lymph node metastases. Parenchyma-saving resections should be preferred.
本研究评估了典型类癌肿瘤切除术后的手术风险，并探讨了决定长期生存的因素。
1976年至1996年，139例连续患者（66例男性和73例女性，平均年龄47±15岁）因典型类癌肿瘤接受开胸手术。102例患者（73.4%）的肿瘤位于中央。
106例患者行根治性切除（7例全肺切除术、13例双叶切除术和86例肺叶切除术），33例患者行保守性切除（3例肺段切除术、3例楔形切除术、20例袖状肺叶切除术和7例袖状支气管切除术）。无术后死亡病例。19例患者（13.7%）出现并发症。支气管成形术后发病率未增加（χ2 = 0.033，无显著性差异）。分期为pT1的患者有107例（77.0%），pT2的患者有32例（23.0%）；13例患者（9.4%）有淋巴结转移。17例患者（12.2%）在随访期间死亡，但只有3例死亡与疾病相关。5年、10年和15年的总生存率分别估计为92.4%、88.3%和76.4%；估计无病生存率在5年时为100%，在10年和15年时为91.4%。有淋巴结转移患者的5年、10年和15年估计生存率均为100%。单因素分析未显示性别、肿瘤大小（T1与T2）、肿瘤位置（中央与外周）和切除类型具有任何预后意义。
这些数据证实，典型类癌肿瘤完整切除后预后良好，包括有淋巴结转移的肿瘤。应优先选择保留实质组织的切除术。
