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THE JOURNAL OF CARDIOVASCULAR SURGERY

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The Journal of Cardiovascular Surgery 1999 August;40(4):607-12

Copyright © 2000 EDIZIONI MINERVA MEDICA

lingua: Inglese

Carcinoid tumors of the lung. An analysis of 65 operated cases

Stefani A., Morandi U., Urgese A. L., Rivasi F.*, Lodi R.

From the Department of Cardio-Thoracic Surgery * Department of Morphological Sciences and Legal Medicine University of Modena, Italy


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Back­ground. The aim of ­this ­study was to ana­lyse two ­groups of ­patients oper­ated for bron­cho­pul­mo­nary neu­ro­en­do­crine neo­plasms (bron­chial car­ci­noid and ­well-dif­fer­en­tiated neu­ro­en­do­crine car­ci­noma) and to inves­ti­gate ­their ­clinico-path­o­log­ical ­data and ­long-­term sur­vival.
­Methods. ­From Jan­uary 1978 to ­June 1996, 65 ­patients ­with bron­chial car­ci­noids under­went oper­a­tion at our Insti­tu­tion. ­There ­were 33 ­males and 32 ­females, ­whose ­mean age was 49.8 ­years. ­Forty-­four neo­plasms (67.7%) ­were con­sid­ered to be cen­tral. His­tology ­revealed 54 typ­ical bron­chial car­ci­noids (83%) and 11 ­well-dif­fer­en­tiated neu­ro­en­do­crine car­ci­nomas (17%). Sur­gical resec­tion of ­tumor and com­plete ­lymph ­node dis­sec­tion was per­formed in all ­cases.
­Results. All ­patients ­entered ­follow-up: 5-­year sur­vival was 91% for ­patients ­with bron­chial car­ci­noid and 49% for ­those ­with ­well-dif­fer­en­tiated neu­ro­en­do­crine car­ci­noma (p<0.05). Uni­var­iate anal­ysis ­found ­that ­there was a sig­nif­i­cant ­decrease in sur­vival ­also for periph­eral loca­tion of the ­tumor, ­advanced path­o­logic ­stage and his­to­log­i­cally pos­i­tive ­lymph ­nodes.
Con­clu­sions. ­These ­results ­point out ­that car­ci­noid ­tumors are malig­nant neo­plasms, so ­they ­require a com­plete and rad­ical sur­gical resec­tion. ­Most ­tumors are ­only ­locally inva­sive and ­show a low aggres­sive beha­viour; there­fore, ­when pos­sible, it is rec­om­mended to ­attempt a lim­ited resec­tion. ­Frozen sec­tions of bron­chial mar­gins and com­plete lym­phad­e­nec­tomy ­should be rou­tinely per­formed. The ­same cri­teria ­should ­apply to ­well dif­fer­en­tiated neu­ro­en­do­crine car­ci­nomas, ­though ­their beha­viour is ­more aggres­sive.

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