Long-term follow-up after first-line bronchoscopic therapy in patients with bronchial carcinoids.
Thorax
; 70(5): 468-72, 2015 May.
Article
em En
| MEDLINE
| ID: mdl-25777586
ABSTRACT
BACKGROUND:
Carcinoid of the lung is considered to be a low-grade malignancy. A subgroup presents as an endobronchial tumour. Surgical resection is considered the standard approach because of its metastatic potential and the possibility of an iceberg phenomenon for the endobronchial subgroup. Advances in non-invasive and minimally invasive technologies seem to justify a more lung parenchyma-sparing approach.METHODS:
In patients presenting with bronchial carcinoids, initial bronchoscopic treatment (IBT) is first attempted for complete tumour eradication and sufficient tissue sampling for the proper differentiation of typical (TC) versus atypical (AC) histological type. Furthermore in cases with postobstruction problems the desobstruction is aimed at improving the patient's condition and by that alleviate surgery if that is needed. High resolution CT is performed 6â weeks post IBT to determine local tumour growth. Surgical resection follows in case of extraluminal disease, residual carcinoid inaccessible for IBT, or late recurrences not salvaged by repeat IBT.RESULTS:
Minimum follow-up was 5â years from start of treatment for 112 patients (65 women, 47 men), with a median age of 47â years (range 16-77 years). Eighty-three patients (74%) had TC, and 29 (26%) AC. IBT only was ultimately curative in 42% of the cases (47/112) 42 TC, 5 AC. Disease-specific mortality including surgical mortality has been 2.6% (3/112) in patients with extraluminal carcinoids (3 AC).CONCLUSIONS:
IBT, if with unsuccessful rescue surgery, is justifiable with excellent long-term outcome. IBT made surgery unnecessary in 42% of the cases. Iceberg phenomenon and metastatic potential in this group of patients with bronchial carcinoids are clinically insignificant.Palavras-chave
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Base de dados:
MEDLINE
Assunto principal:
Neoplasias Brônquicas
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Broncoscopia
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Tumor Carcinoide
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Recidiva Local de Neoplasia
Idioma:
En
Ano de publicação:
2015
Tipo de documento:
Article
País de afiliação:
Holanda