Surgical Management and Prognostic Factors in Pulmonary Carcinoid Tumors: A Single-Center Experience

Öz

Objective: Pulmonary carcinoid tumors are rare neuroendocrine tumors with low malignant potential, for which surgical resection remains the gold standard. The aim of this study is to evaluate the clinicopathological characteristics, symptomatology, surgical procedures performed, and long-term survival outcomes of patients operated on for pulmonary carcinoid tumors in our clinic, with a focus on histopathological subtypes. Material and Methods: Data of 41 patients who underwent surgical treatment for pulmonary carcinoid tumors were analyzed retrospectively. Patients were divided into two groups based on histopathology: typical and atypical carcinoids. Demographic data, presenting symptoms, tumor characteristics, surgical procedures, and survival rates were analyzed. Survival analyses were performed using the Kaplan-Meier method, and inter-group comparisons were made using Log-rank and Mann-Whitney U tests. Results: The mean age of the 41 patients (26 Females, 15 Males) included in the study was 49 ±12.7 years. At presentation, 43.9% (n=18) of the patients were asymptomatic; among symptomatic patients, cough (22%) and dyspnea (14.6%) were the most common complaints. Histopathological examination revealed typical carcinoid in 32 (78%) patients and atypical carcinoid in 9 (22%) patients. The most common surgical procedure was lobectomy (58.5%), while the rate of parenchyma-sparing surgery was 26.8%. The mean follow-up period was 133.8±54.5 months. The 5-year overall survival rate was 93.8% in the typical carcinoid group and 88.9% in the atypical carcinoid group. No statistically significant difference was found between the two groups in terms of survival (p=0.336). Conclusion: Surgical resection is a safe treatment option for pulmonary carcinoid tumors with low complication rates and high survival outcomes. The fact that a significant proportion of patients are asymptomatic suggests an increase in incidental diagnoses. In early-stage atypical carcinoids treated with complete resection, long-term results comparable to typical variants can be achieved.

Anahtar Kelimeler

• Pulmonary carcinoid tumor
• neuroendocrine tumor
• lung surgery
• survival
• lymph node involvement.

Destekleyen Kurum

The authors declared that this study has received no financial support.

Proje Numarası

Proje No:GO 20/507 , Karar No:2020/11-35

Etik Beyan

Ethical approval was obtained from the Hacettepe University Ethics Committee (Project No: GO 20/507, Decision No: 2020/11-35).

AKCİĞER KARSİNOİD TÜMÖRLERİNDE CERRAHİ TEDAVİ VE PROGNOSTİK FAKTÖRLER:TEK MERKEZ DENEYİMİ

Öz

Amaç: Akciğer karsinoid tümörleri, düşük malignite potansiyeline sahip olmasına rağmen cerrahi rezeksiyonun altın standart olduğu nadir nöroendokrin tümörlerdir. Bu çalışmanın amacı, kliniğimizde opere edilen akciğer karsinoid tümörlü hastaların klinikopatolojik özelliklerini, başvuru semptomlarını, uygulanan cerrahi yöntemleri ve uzun dönem sağkalım sonuçlarını histopatolojik alt tipler eşliğinde değerlendirmektir. Gereç ve Yöntemler: Kliniğimizde akciğer karsinoid tümörü tanısı ile cerrahi tedavi uygulanan 41 hastanın verileri retrospektif olarak incelendi. Hastalar histopatolojik olarak tipik ve atipik karsinoid olmak üzere iki gruba ayrıldı. Demografik veriler, başvuru şikâyetleri, tümör özellikleri, cerrahi prosedürler ve sağkalım durumları analiz edildi. Sağkalım analizleri Kaplan-Meier yöntemi ile, gruplar arası karşılaştırmalar Log-rank ve Mann-Whitney U testleri ile yapıldı. Bulgular: Çalışmaya dahil edilen 41 hastanın (26 Kadın, 15 Erkek) yaş ortalaması 49,0±12,7 yıldı. Başvuru anında hastaların %43,9’unun (n=18) asemptomatik olduğu, semptomatik hastalarda ise en sık öksürük (%22) ve nefes darlığı (%14,6) görüldüğü saptandı. Histopatolojik incelemede 32 (%78) hastada tipik, 9 (%22) hastada atipik karsinoid mevcuttu. En sık uygulanan cerrahi yöntem lobektomi (%58,5) iken, parankim koruyucu cerrahi oranı %26,8 idi. Ortalama takip süresi 133,8±54,5 aydı. Beş yıllık genel sağkalım oranı tipik karsinoid grubunda %93,8, atipik karsinoid grubunda %88,9 olarak bulundu. İki grup arasında sağkalım açısından istatistiksel olarak anlamlı fark saptanmadı (p=0,336). Sonuç: Akciğer karsinoid tümörlerde cerrahi rezeksiyon, düşük komplikasyon ve yüksek sağkalım oranları ile güvenli bir tedavi seçeneğidir. Hastaların önemli bir kısmının asemptomatik olması, insidental tanıların arttığını göstermektedir. Erken evrede yakalanan ve tam rezeksiyon uygulanan atipik karsinoidlerde de tipik varyantlar kadar yüz güldürücü uzun dönem sonuçları elde edilebilir.

Anahtar Kelimeler

• Akciğer karsinoid tümörü
• nöroendokrin tümör
• akciğer cerrahisi
• sağkalım
• lenf nodu tutulumu

Destekleyen Kurum

Çalışmada hiçbir kurum ya da kişiden finansal destek alınmamıştır.

Proje Numarası

Proje No:GO 20/507 , Karar No:2020/11-35

Etik Beyan

Hacettepe Üniversitesi Etik Kurulu’ndan onay alındı (Proje No:GO 20/507 , Karar No:2020/11-35)

Kaynakça

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