Neuroendocrine Tumors of the Lung With Surgical Resection and Lymph Node Dissection in a Tertiary Thoracic Surgery Center
| Autor: | Achim D, M Davidescu, Motaş C, E Jianu, Natalia Motas, Rus O, T Horvat |
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| Rok vydání: | 2018 |
| Předmět: |
medicine.medical_specialty
Endocrine Care Endocrine and Autonomic Systems business.industry Endocrinology Diabetes and Metabolism Large cell medicine.medical_treatment 030230 surgery Neuroendocrine tumors medicine.disease 03 medical and health sciences Dissection 0302 clinical medicine Endocrinology Lymphatic system medicine.anatomical_structure Cardiothoracic surgery 030220 oncology & carcinogenesis medicine Lymphadenectomy Radiology Lung cancer business Lymph node |
| Zdroj: | Acta Endocrinologica (Bucharest). 14:219-226 |
| ISSN: | 1843-066X 1841-0987 |
| DOI: | 10.4183/aeb.2018.219 |
| Popis: | Context Management of neuroendocrine tumors is highly dynamic, in both diagnosis and treatment. Objective Surgical resection with lymph node approach offers excellent 5-years survival. Design Between 2008 and 2011 we operated with radical intent 326 lung cancers. Patients and methods Cases without lymph node approach were excluded. We found 38 neuroendocrine malignancies: 12 typical carcinoids, 3 atypical carcinoids, 4 large cell neuroendocrine carcinomas (LCNEC) and 10 small-cell lung cancers (SCLC). Limits of the study are: variable lymphadenectomy technique; absence of PET - CT and EBUS-TBNA (EndoBronchial UltraSound - TransBronchial Needle Aspiration) for staging; incomplete data for disease-free survival. Results We performed 13 pneumonectomies, 22 lobectomies and 3 non-anatomical resections. There were 5 bronchoplasties. The 5-year survival difference between NSCLC (non-small-cell lung cancer - 42.9%) and SCLC (40.53% - one of the best from the literature) is not statistically significant (p=0.4780). Five-years survival was 100% for typical and atypical carcinoids - the best published. We found lymph node metastasis in 2 typical carcinoids, in 2 atypical carcinoids and in 6 SCLCs. Conclusions For typical and atypical carcinoids, radical resection with lymphadenectomy offers 100% 5-years survival. Early-stage SCLC may benefit from radical resection; lymph node dissection is mandatory because of the well-known precocious lymphatic dissemination. |
| Databáze: | OpenAIRE |
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