Carcinoid tumors of the lung and multimodal therapy

Aim: To report our experience with bronchial carcinoids. Methods: From January 1990 to March 2003 we treated 42 such patients, 30 females and 12 males. All patients underwent preoperative total body computed tomography (CT), total body In-111 octreotide scintigraphy, and SPECT of the thorax, with evaluation of serum levels of CEA, CgA, NSE, and urinary 5-HIAA. Diagnosis was obtained in 28 patients with fibre-optic bronchoscopy and in 14 patients with CT-guided trans-thoracic needle biopsy. Results: There were 26 typical and 16 atypical carcinoids. 30 lobectomies, 5 bilobectomies, 6 wedge resections, and 1 pneumonectomy were carried out. The 3-year and the 5-year survival rates in the typical and atypical carcinoid groups were 100% and 96% vs. 81% and 68%, respectively (p < 0.001). Conclusions: Longterm survival is based on histological completeness of surgical treatment. Octreotide scintigraphy and SPECT document N-1 and N-2 precisely.