Surgical Management of Primary Pulmonary Carcinoid Tumors.

Objective: Primary pulmonary carcinoid tumors constitute 1% to 2% of primary lung neoplasms, with limited surgical outcome data due to the rarity of these neoplasms. The aim of our study was to review the complications and long-term outcomes following surgery for primary pulmonary carcinoid neoplasms.

Methods: With institutional review board approval, the charts of patients with lung neoplasms from 2000-2022 were reviewed. In total, 605 total charts were reviewed, with 535 excluded for not having a primary pulmonary carcinoid tumor or not receiving surgical treatment. Typical, atypical, and cumulative survival rates were calculated along with complications.

Results: Major presenting symptoms included 31% (n = 22) persistent cough, 30% (n = 21) dyspnea, 9% (n = 6) hemoptysis, and 7% (n = 5) constitutional symptoms (fever, weight loss, and/or night sweats). Fifty-one percent (n = 36) were found incidentally, and 14% (n = 10) had unknown presentation. There were complications in 26 patients (41%). Minor complications included chest wall pain (n = 6), chest tube air leak (n = 4), dyspnea (n = 3), atelectasis (n = 2), ileus (n = 2), postpneumonectomy syndrome (n = 1), and chronic cough (n = 1). Serious complications included atrial fibrillation (n = 2), respiratory failure (n = 1), hemothorax (n = 1), hypovolemic shock (n = 1), and intraoperative tension pneumothorax (n = 1). No patients died during surgery or secondary to any complications of surgery.

Outcomes: The cumulative 2-year survival rate was 98.5%, and the cumulative 5-year survival rate was 96.3%. There were seven total deaths during the study period, but the cause of death was not reported.

Conclusions: This study confirms that resection of primary pulmonary carcinoid tumors is relatively low risk, with excellent long-term survival rates.