BRONCHOSCOPIC TREATMENT OF INTRALUMINAL TYPICAL CARCINOID - A PILOT-STUDY

Objective: The curative potential of various bronchoscopic treatments such as Nd:YAG laser, photodynamic therapy, and brachytherapy for the treatment of intraluminal tumor has been reported previously. Bronchos copic treatment can be used to treat small intraluminal tumor with cur ative intent, such as in patients with roentgenologically occult squam ous cell cancer. In a retrospective study, we showed that bronchoscopi c treatment provided excellent local control with surgical proof of cu re in 6 of 11 patients with intraluminal typical bronchial carcinoid, Methods: In a prospective study, 19 patients (8 women and 11 men) with resectable intraluminal typical bronchial carcinoid have undergone br onchoscopic treatment under general anesthesia. Median age was 44 year s (range, 20-74 years). If tumor persisted after 2 bronchoscopic treat ment sessions, surgery was performed within 4 months after the treatme nt. Results: Bronchoscopic treatment was able to completely eradicate tumor in 14 of the 19 patients (complete response rate 73%, 95% CI: 49 %-91%). Median follow-up of these patients is 29 months (range, 8-62 m onths). One patient had severe cicatricial stenosis after bronchoscopi c treatment, and sleeve lobectomy was necessary. No residual carcinoid was found ill the resected specimen. In the remaining 5 patients, bro nchoscopic treatment did not result in a complete response and radical surgical resection was performed afterward with confirmation of resid ual carcinoid in the resected specimen. Median follow-up of the surgic al group is 34 months (range, 12-62 months). Conclusions: Current data suggest that bronchoscopic treatment may be an effective alternative to surgical resection in a subgroup of patients with resectable intral uminal typical bronchial carcinoid. It alleviated the necessity of sur gical resection in 68% (95% CI: 43%-87%) of the patients.