Bronchopulmonary Carcinoids: An Analysis of 26 Cases

Bronchopulmonary carcinoids comprise about 5% of all primary tumors of the lung. Though more benign in nature, bronchopulmonary carcinoids have a potential for local invasion, regional nodal involvement, and distant metastasis. From 1977 to 1998, 26 patients were admitted to our section with surgical proof of bronchopulmonary carcinoids. They were classified into two subtypes: typical and atypical carcinoids. We retrospectively analyzed the clinical data, diagnostic rate, surgical results, and prognostic factors. Of these 26 patients, 22 patients had typical carcinoids and 4 atypical. The mean age was 57.4 years, with a range of 34 to 79 years. Sixteen were male and 10 were female. Ten patients were smokers. The most common presenting symptom was cough (76.9%), followed by hemoptysis (38.5%). Carcinoid syndrome was observed in 2 patients. The tumors were predominantly localized in the right middle lobe (34.6%), with a right-sided preference in 73% of the cases. Lobectomy was the treatment of choice for most of our patients. No surgical morbidity or mortality was noted. Eight patients had a 10-year disease-free survival, and 13 patients had a 5-year disease-free survival. The prognostic factors that were analyzed included clinical presentation, surgical method, pathological subtype, regional lymph node metastasis, and distal metastasis. Only distal metastasis could influence survival. In conclusion, we believe that surgical resection for typical carcinoids is sufficient; but a more aggressive treatment for atypical carcinoids is needed, especially in cases with nodal or distal metastasis.