Management of Carcinoid Tumors

被引:143
作者
Detterbeck, Frank C. [1 ]
机构
[1] Yale Univ, Sch Med, New Haven, CT 06520 USA
关键词
CELL LUNG-CANCER; FORTHCOMING 7TH EDITION; 20 YEARS EXPERIENCE; LONG-TERM SURVIVAL; BRONCHIAL CARCINOIDS; NEUROENDOCRINE TUMORS; PULMONARY CARCINOIDS; SURGICAL-MANAGEMENT; TNM CLASSIFICATION; STAGING PROJECT;
D O I
10.1016/j.athoracsur.2009.07.097
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Primary bronchopulmonary carcinoids comprise a significant proportion of carcinoid tumors. The clinical presentation allows prediction of the diagnosis and cell type and directs evaluation and treatment. Young age, central tumor, and no nodal enlargement are highly suggestive of typical carcinoid. These patients require no further diagnostic or staging tests beyond chest computed tomography and bronchoscopy before resection using parenchyma-sparing techniques. All bronchopulmonary carcinoids are malignant (though indolent), and surgical intervention is the mainstay of treatment. Mediastinos copy is suggested when there is moderate suspicion of atypical carcinoid (central cN1 or peripheral cN0), with lobectomy and lymphadenectomy if the mediastinal nodes are benign. For a high suspicion of atypical carcinoid (central cN2, peripheral cN1, 2), imaging for distant metastases and mediastinoscopy is suggested, with multimodality treatment for an atypical carcinoid with N2 involvement. (Ann Thorac Surg 2010; 89: 998-1005) (C) 2010 by The Society of Thoracic Surgeons
引用
收藏
页码:998 / 1005
页数:8
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