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The Annals of Thoracic Surgery, Vol 54, 50-54, Copyright © 1992 by The Society of Thoracic Surgeons
DH Harpole Jr, JM Feldman, S Buchanan, WG Young and WG Wolfe
From 1970 until 1990, 8,958 cases of primary carcinoma of the lung were
diagnosed at the Duke University Medical Center. During the same period,
126 patients (mean age, 53 +/- 13 years) were diagnosed with bronchial
carcinoid. The overall survival was 78% for 5 years and 71% for 10 years.
Surgical treatment in 106 patients included pneumonectomy (15), lobectomy
(63 with 9 bronchoplastic procedures), stapled wedge resection (22), and
bronchoscopic laser resection (6). The method of diagnosis was chest
roentgenography (121), chest computed tomography (77), mediastinal
tomography (31), bronchoscopy (81), bronchoscopic brushing and washing
(50), bronchoscopic biopsy (40), transthoracic needle biopsy (27),
thoracotomy (100), and autopsy (5). Univariate analysis of the medical
history, presenting signs and symptoms, diagnostic test results, and
pathologic data predicted improved survival (p less than 0.001) for: female
sex (n = 58), asymptomatic presentation (n = 47), normal serum serotonin or
urinary hydroxyindoleacetic acid levels (n = 76), peripheral location of
the primary tumor (n = 50), pathologic stage I or II (n = 91), negative
lymph nodes (n = 80), primary tumor 2 cm or less in diameter (n = 67), and
typical histology (n = 80). No significance (p greater than 0.1) was
observed for age, smoking history, race, family history of carcinoid,
environmental exposure, or hemoptysis. The most important factors affecting
survival defined by multivariate analysis were (p less than 0.01)
pathologic stage, atypical histology, and asymptomatic presentation.
Bronchial carcinoid tumors are unique, making up 1% to 2% of primary lung
neoplasms and having an excellent prognosis after resection with a 95%
5-year and 93% 10-year survival for pathologic stage I disease.
ARTICLES
Bronchial carcinoid tumors: a retrospective analysis of 126 patients
Department of Surgery, Duke University Medical Center, Durham, North Carolina 27710.
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