Endobronchial Treatment for Bronchial Carcinoid: Patient Selection and Predictors of Outcome

被引:35
作者
Reuling, Ellen M. B. P. [1 ,6 ]
Dickhoff, Chris [1 ,2 ]
Plaisier, Peter W. [6 ]
Coupe, Veerle M. H. [3 ]
Mazairac, Albert H. A. [4 ]
Lely, Rutger J. [4 ]
Bonjer, H. Jaap [1 ]
Daniels, Johannes M. A. [5 ]
机构
[1] Vrije Univ Amsterdam Med Ctr, Dept Surg, Boelelaan 1117, NL-1081 HV Amsterdam, Netherlands
[2] Vrije Univ Amsterdam Med Ctr, Dept Cardiothorac Surg, Amsterdam, Netherlands
[3] Vrije Univ Amsterdam Med Ctr, Dept Epidemiol & Stat, Amsterdam, Netherlands
[4] Vrije Univ Amsterdam Med Ctr, Dept Radiol & Nucl Med, Amsterdam, Netherlands
[5] Vrije Univ Amsterdam Med Ctr, Dept Pulm Dis, Amsterdam, Netherlands
[6] Albert Schweitzer Hosp, Dept Surg, Dordrecht, Netherlands
关键词
Bronchial carcinoid; Endobronchial treatment; Prognostic factors; Bronchoscopy; Neuroendocrine tumor; ESTS NEUROENDOCRINE TUMORS; EUROPEAN ASSOCIATION; PROGNOSTIC-FACTORS; WORKING GROUP; LUNG; EXPERIENCE; RESECTION; THERAPY; PET; GA-68-DOTATOC;
D O I
10.1159/000484984
中图分类号
R56 [呼吸系及胸部疾病];
学科分类号
摘要
Background: Traditionally, surgical resection is the preferred treatment for typical carcinoids and atypical carcinoids located in the lungs. Recently however, several studies have shown excellent long-term outcome after endobronchial treatment of carcinoid tumors located in the central airways. This study investigates clinical and radiological features as predictors of successful endobronchial treatment in patients with a bronchial carcinoid tumor. Objectives: To identify clinical and radiological features predictive of successful endobronchial treatment in patients with bronchial carcinoid. Methods: This analysis was performed in a cohort of patients with typical and atypical bronchial carcinoid referred for endobronchial treatment. Several patient characteristics, radiological features, and histological grade (typical or atypical carcinoid) were tested as predictors of successful endobronchial treatment. Results: One hundred and twenty-five patients with a diagnosis of bronchial carcinoid underwent endobronchial treatment. On multivariate analysis, a tumor diameter <15 mm (odds ratio 0.09; 95% confidence interval 0.02-0.5; p = <0.01) and purely intraluminal growth on computer tomography (CT scan) (odds ratio, 9.1; 95% confidence interval 1.8-45.8; p = <0.01) were predictive of radical endobronchial treatment. The success rate for intraluminal tumors with a diameter <20 mm was 72%. Conclusions: Purely intraluminal disease and tumor diameter on CT scan seem to be independent predictors for successful endobronchial treatment in patients with bronchial carcinoid. Based on these data, patients with purely intraluminal carcinoid tumors with a diameter <20 mm on CT scan are good candidates for endobronchial treatment, regardless of histological grade. In contrast, all patients with a tumor diameter >= 20 mm should be directly referred for surgery. (C) 2018 S. Karger AG, Basel
引用
收藏
页码:220 / 227
页数:8
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