Long-term follow-up after first-line bronchoscopic therapy in patients with bronchial carcinoids
| Autor: | Thomas G. Sutedja, Pieter E. Postmus, Hes A.P. Brokx, Marinus A. Paul |
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| Přispěvatelé: | Surgery, Cardio-thoracic surgery, Pulmonary medicine, CCA - Innovative therapy, Pulmonary Medicine |
| Rok vydání: | 2015 |
| Předmět: |
Pulmonary and Respiratory Medicine
Adult Male medicine.medical_specialty Neoplasm Residual Adolescent Long term follow up First line High resolution Carcinoid Tumor Malignancy Young Adult Clinical Protocols Bronchoscopy medicine Humans In patient Pneumonectomy Aged Lung business.industry Bronchial Neoplasms Surgical mortality Tissue sampling Middle Aged medicine.disease Surgery medicine.anatomical_structure Treatment Outcome Female Neoplasm Recurrence Local business Follow-Up Studies |
| Zdroj: | Brokx, H A P, Paul, M A, Postmus, P E & Sutedja, T G 2015, ' Long-term follow-up after first-line bronchoscopic therapy in patients with bronchial carcinoids ', Thorax, vol. 70, no. 5, pp. 468-472 . https://doi.org/10.1136/thoraxjnl-2014-206753 Thorax, 70(5), 468-472. BMJ Publishing Group |
| ISSN: | 0040-6376 |
| DOI: | 10.1136/thoraxjnl-2014-206753 |
| Popis: | Background Carcinoid of the lung is considered to be a low-grade malignancy. A subgroup presents as an endobronchial tumour. Surgical resection is considered the standard approach because of its metastatic potential and the possibility of an iceberg phenomenon for the endobronchial subgroup. Advances in non-invasive and minimally invasive technologies seem to justify a more lung parenchyma-sparing approach. Methods In patients presenting with bronchial carcinoids, initial bronchoscopic treatment (IBT) is first attempted for complete tumour eradication and sufficient tissue sampling for the proper differentiation of typical (TC) versus atypical (AC) histological type. Furthermore in cases with postobstruction problems the desobstruction is aimed at improving the patient9s condition and by that alleviate surgery if that is needed. High resolution CT is performed 6 weeks post IBT to determine local tumour growth. Surgical resection follows in case of extraluminal disease, residual carcinoid inaccessible for IBT, or late recurrences not salvaged by repeat IBT. Results Minimum follow-up was 5 years from start of treatment for 112 patients (65 women, 47 men), with a median age of 47 years (range 16–77 years). Eighty-three patients (74%) had TC, and 29 (26%) AC. IBT only was ultimately curative in 42% of the cases (47/112): 42 TC, 5 AC. Disease-specific mortality including surgical mortality has been 2.6% (3/112) in patients with extraluminal carcinoids (3 AC). Conclusions IBT, if with unsuccessful rescue surgery, is justifiable with excellent long-term outcome. IBT made surgery unnecessary in 42% of the cases. Iceberg phenomenon and metastatic potential in this group of patients with bronchial carcinoids are clinically insignificant. |
| Databáze: | OpenAIRE |
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