Surgical treatment in patients with neuroendocrine (carcinoid) tumors of the trachea, bronchus, and lung

Introduction. In the latest 2015 WHO Classification of Lung Tumors, carcinoid tumors are presented in the group of neuroendocrine tumors and divided into typical carcinoid tumors (8240/3) and atypical carcinoid tumors (8249/3). They have certain traits that should be considered when diagnosing and choosing a surgical treatment option for this disease. Material and methods. The investigation was based on a retrospective analysis of 106 case histories of patients with a carcinoid tumor of the trachea, bronchi and lung, of whom 104 (98.1%) patients underwent surgical treatment. The patients’ mean age was 46.0 years. Carcinoid tumors were rarely observed in patients younger than 20 years of age and in those older than 70 years. Women predominated, amounting to 61.3%; typical carcinoids were noted in 60.4% of patients and equally distributed among men and women. The central form of a tumor was detected in most patients (n=87, 82.1%), which was located in the trachea (n=11), main bronchus (n=22) and lobar and segmental bronchi (n=55). Results. Specifying diagnosis used before surgical treatment and during surgery (bronchotomy), as well as tracheal and bronchial reconstruction surgery allowed for organ-sparing surgery in most patients (n=94, 90.4%), including 17 (16.4%) patients with complete lung preservation. Reconstruction surgery for central carcinoids accounted for 75.9%. Postoperative complications were observed in 3.8%; the mortality rate was 1.9%. Conclusion. Carcinoid tumors are characterized by a relatively safe course (especially their typical histological forms) that does not rule out the manifestation of malignant traits of a tumor — distant hematogenous and local lymphogenous metastases. Tracheal and bronchial carcinoids are characterized by an exophytic growth, which allows for organ-sparing reconstruction surgery, including those with complete lung preservation.