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CURRENT ISSUETHE JOURNAL OF CARDIOVASCULAR SURGERY

A Journal on Cardiac, Vascular and Thoracic Surgery


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The Journal of Cardiovascular Surgery 2000 February;41(1):131-5

THORACIC PAPERS 

 ORIGINAL ARTICLES

Atypical bronchial carcinoids. Reviews of 46 patients

Oliaro A., Filosso P.L., Donati G., Ruffini E.

From the Department of Thoracic Surgery University of Turin, Italy Azienda Ospedaliera San Giovanni Battista, Torino, Italy

Background. The pur­pose of ­this ­study was to ­assess the beha­vi­our of atyp­i­cal car­ci­noids oper­at­ed at our Department in the peri­od 1977-1998 and to ­review the ­last 19 cas­es accord­ing to Capella’s clas­sifi­ca­tion (1994), indi­cat­ing the ­most ade­guate sur­gi­cal ­approach.
Methods. On the ­basis of ana­to­mo-path­o­log­i­cal char­ac­ter­is­tics, we ­have ­reviewed sur­gi­cal treat­ment and out­come in 46 ­patients, sub­mit­ted in the ­last 22 ­years to sur­gi­cal resec­tion for neu­ro­en­do­crine neo­plasms.
Results. 5-­year sur­vi­val is 77.2%; 10-­year sur­vi­val is 53.2%. Lymph ­node metas­ta­ses are ­also impor­tant for sur­vi­val, but ­less ­than the his­to­type. The ­review of our ­last six ­years’ ­series, accord­ing to Capella’s clas­sifi­ca­tion, of 19 ­patients affect­ed by so-­called atyp­i­cal car­ci­noids ­revealed ­that: 5 ­were ­well dif­fer­en­tiat­ed neu­ro­en­do­crine ­tumors (­WDNT), 12 ­were ­well dif­fer­en­tiat­ed neu­ro­en­do­crine car­ci­no­mas (­WDNC), 2 ­were ­small ­cell neu­ro­en­do­crine car­ci­no­mas (­SCLC). The 5-­year over­all sur­vi­val of our cas­es is 78%, for the ­WDNT 100%, for ­WDNC 81.2%. Of the 2 ­patients ­with ­SCLC, one sur­vived 2 ­months; the oth­er is ­still ­alive 5 ­months ­after sur­gery.
Conclusions. The ­authors con­clude ­that 5-­year and 10-­year sur­vi­val are strong­ly relat­ed to the his­to­log­i­cal ­type of neu­ro­en­do­crine neo­plasm and to the pres­ence of lymph ­node metas­ta­ses. Capella’s ana­to­mo-path­o­log­i­cal clas­sifi­ca­tion ­helps to ­give a ­more accu­rate prog­no­sis for sur­vi­val in so-­called “atyp­i­cal car­ci­noids”. If the neo­plasm is malig­nant, the ­authors rec­om­mend rad­i­cal resec­tion, if pos­sible.

language: English


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