Lung carcinoid tumors: the five-year experience of a portuguese thoracic department

Abstract

Introduction: Surgical resection is the primary therapy for typical (TC) and atypical carcinoid (AC) tumors and recurrence is uncommon. AC have a worse prognosis compared to TC.

Objective: To analyze patients with TC and AC submitted to surgical treatment and assess differences between both tumors.

Methods: Retrospective analysis of confirmed lung TC and AC submitted to surgical treatment between 2014 and 2018 in a thoracic surgery unit of a tertiary hospital was made.

Results: Ninety-two admissions (N=86 patients) were included, 47% with TC and 53% with AC. A statistically significant difference between genders was observed (67% females). In males, AC was diagnosed in 70%. Mean age was 64±11 years and 42% were asymptomatic. Smoking habits were observed in 39%, especially in the AC group. Median dimension of lesions in CT scan was 17mm. PET-CT was performed in 76% and positive in 87%. The median SUV was 3.4 (3.8), with no statistically significant difference between groups. Lobectomy was performed in 59%, wedge resection in 27%, segmentectomy in 11% and bilobectomy in 3%. The surgical approach was thoracotomy in 56% and VATS in 44%. The median length of hospital stay was 7 days. The median histological greater dimension of lesions was 16mm. Stage I was observed in 84% of TC and 65% of AC, II in 12% of TC and 16% of AC, IIIA in 10% of AC, IVA in 5% of TC and 8% of AC. Only 7 patients died during follow-up (5 with AC and 2 of them with stage IV disease).

Conclusions: This study reinforces the importance of surgery in the treatment of carcinoid tumors specially in early stages, showing that recurrence is rare. Differences seem to exist in smoking habits, sex, staging and prognosis.