Carcinoid tumors of the lung - An analysis of 65 operated cases

Background The aim of this study was to analyse two groups of patients oper ated for bronchopulmonary neuroendocrine neoplasms (bronchial carcinoid and well-differentiated neuroendocrine carcinoma) and to investigate their cli nico-pathological data and long-term survival. Methods. From January 1978 to June 1996, 65 patients with bronchial carcino ids underwent operation at our Institution. There were 33 males and 32 fema les, whose mean age was 49.8 years. Forty-four neoplasms (67.7%) were consi dered to be central. Histology revealed 54 typical bronchial carcinoids (83 %) and 11 well-differentiated neuroendocrine carcinomas (17%), Surgical res ection of tumor and complete lymph node dissection was performed in all cas es, Results, All patients entered follow-up: 5-year survival was 91% for patien ts with bronchial carcinoid and 49% for those with well-differentiated neur oendocrine carcinoma (p<0.05). Univariate analysis found that there was a s ignificant decrease in survival also for peripheral location of the tumor, advanced pathologic stage and histologically positive lymph nodes. Conclusions. These results point out that carcinoid tumors are malignant ne oplasms, so they require a complete and radical surgical resection, Most tu mors are only locally invasive and show a low aggressive behaviour; therefo re, when possible, it is recommended to attempt a limited resection, Frozen sections of bronchial margins and complete lymphadenectomy should be routi nely performed. The same criteria should apply to well differentiated neuro endoctine carcinomas, though their behaviour is more aggressive.