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Ann Thorac Surg 1989;47:412-414
© 1989 The Society of Thoracic Surgeons

Articles

Bronchial carcinoids: A review of 60 patients

Federico Rea, MD*, Rino Binda, MD, Giorgio Spreafico, MD, Francesco Calabrò, MD, Luigi Bonavina, MD, Angiolo Cipriani, MD, Giuseppe Di Vittorio, MD, Ambrogio Fassina, MD, Francesco Sartori, MD

First Department of Surgery, Department of Pneumology, and Third Department of Pathology, University of Padua, Padua, Italy

Accepted for publication September 20, 1988.

* Address reprint requests to Dr Rea, Clinica Chirurgica 1, Università di Padova, via Giustiniani 2, 35100, Padova, Italy.

Sixty patients with a bronchial carcinoid underwent surgical treatment. Preoperative fiberoptic bronchoscopy revealed a characteristic pink, smooth, bleeding tumor in 71.4% of the patients with a typical carcinoid and 16.7% of those with an atypical carcinoid (p < 0.05) Eight pneumonectomies, seven bilobectomies, 34 lobectomies, three lobectomies with bronchoplasty, six bronchotomies with bronchoplasty, and two segmental resections were performed. All patients entered follow-up, and 47 were followed for more than 5 years. Ten-year survival was 89.6% for patients with a typical carcinoid and 60% for those with an atypical carcinoid. Ten-year survival was 88.1% for patients with carcinoids without lymph node involvement. All patients with lymph node involvement died within 5 years. Overall, 5 of the 8 patients having pneumonectomy died of acute cardiorespiratory failure. We conclude that a limited surgical resection with or without bronchoplasty and systematic lymphadenectomy is the procedure of choice in patients with typical carcinoids. On the other hand, atypical carcinoids are comparable to well-differentiated malignancies of the lung. Whenever possible, pneumonectomy should be avoided in favor of bronchial sleeve resection.




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