ANALYSIS OF THE OUTCOMES OF SURGICAL TREATMENT IN PATIENTS WITH BRONCHOPULMONARY CARCINOID TUMORS

Abstract

Inroduction. Surgical resection of bronchopulmonary carcinoid tumors remains the primary treatment modality and provides good outcomes. There exists debate, however, about the optimal extent of resection for this disease. Lung-sparing bronchial sleeve resections have been the priority approach in the past decades. Aim. Statistical analysis to determine the long-term outcomes of different surgical approaches for bronchopulmonary carcinoid tumors was conducted. Materials and methods. From 2005 through 2022, 124 patients who underwent surgical resection of pulmonary carcinoid tumors were reviewed. Results were processed using mathematical statistics (descriptive statistics, exploratory data analysis, Student's correlation t-test, chi quadrant test and Kaplan-Meier analysis) using the IBM SPSS v23 statistical package. Results. There were 124 patients who underwent surgical resection of pulmonary carcinoid tumors from 2005 through 2022. All patients received complete resection of their tumors, with 32,3% (40/124) of patients undergoing isolated bronchial sleeve resection, 4,0% (5/124) of patients undergoing bronchial sleeve resections and parenchyma-sparing resection. In the case of peripheral tumors 15,3% (19/124) of patients underwent sublobar resection, 4,8% (6/124) of patients underwent lobectomy and 0,8% (1/124) of patients underwent segmentectomy. There were no peri-operative mortalities. Median follow-up was 1949 days. Overall 5- and 10-year survival was 75,1 % and 73,4 % respectively. Overall survival in patients with typical carcinoid and atypical carcinoid was 69,3 % and 73,2 % respectively. When comparing lobar resection and parenchyma-sparing bronchial sleeve resection according to the Kaplan-Meier survival function, Student's t test, Spearman's correlation, the risk of metastases and tumor recurrence in patients does not depend on the type of surgery that was performed. Conclusions. Excellent long-term outcomes can be achieved following surgical resection of pulmonary carcinoid tumors. When comparing survival in patients who underwent lobar resections and parenchyma-sparing resections with central tumor localization, there is no significant difference in the risk of metastases or tumor recurrence. The risk of metastases decreases over time, regardless of the type of surgery performed.

Keywords

• lung carcinoid
• surgical treatment
• long-term outcomes
• mathematical statistics