Abstract
Carcinoids are rare in the thoracic surgery field and can be generally divided into primary pulmonary and primary thymic carcinoids. Although they are considered low-grade malignant tumors, occasionally they show a poor prognosis, especially in patients with atypical carcinoids . In this study, 28 patients with pulmonary carcinoids and 11 thymic carcinoids underwent operations at our department and were analyzed comparatively using clinical factors.
The 28 pulmonary carcinoids account for 0.83% of all 3371 resected lung cancers in our department, while the 11 thymic carcinoids account for 1.67% of all 662 mediastinal tumors resected.
There were no significant differences in sex or age distributions . About 60% of the patients were asympomatic and they were discovered by chest radiographs in population-based mass screening . The rate of correct pre-operative diagnosis for pulmonary carcinoids is 64.3% (18/28), while that for thymic carcinoids is 40% (2/5). Invasions to adjacent organs were found in cases of thymic carcinoids (27.3%, 3/11). Nodal involvement was observed in 5 of 15 atypical pulmonary carcinoid patients . The five-year survival rate of patients with thymic carcinoids was 38.9%, which was significantly worse than that of patients with pulmonary carcinoids (90.4%).
In patients with thymic carcinoids, local recurrences were frequently observed.
Based on these findings, it is now recommended that systematic nodal dissection should be done for atypical carcinoid patients, and that an adequate surgical margin should be left for thymic carcinoids.
