April - June 2018, Volume 14, Issue 2

Motas N, Motas C, Davidescu M, Achim D, Rus O, Jianu E, Horvat T

Neuroendocrine Tumors of the Lung With Surgical Resection and Lymph Node Dissection in a Tertiary Thoracic Surgery Center

Acta Endo (Buc) 2018, 14 (2): 219-226
doi: 10.4183/aeb.2018.219

Context. Management of neuroendocrine tumors is highly dynamic, in both diagnosis and treatment. Objective. Surgical resection with lymph node approach offers excellent 5-years survival. Design. Between 2008 and 2011 we operated with radical intent 326 lung cancers. Patients and Methods. Cases without lymph node approach were excluded. We found 38 neuroendocrine malignancies: 12 typical carcinoids, 3 atypical carcinoids, 4 large cell neuroendocrine carcinomas (LCNEC) and 10 small-cell lung cancers (SCLC). Limits of the study are: variable lymphadenectomy technique; absence of PET - CT and EBUS-TBNA (EndoBronchial UltraSound - TransBronchial Needle Aspiration) for staging; incomplete data for disease-free survival. Results. We performed 13 pneumonectomies, 22 lobectomies and 3 non-anatomical resections. There were 5 bronchoplasties. The 5-year survival difference between NSCLC (non-small-cell lung cancer - 42.9%) and SCLC (40.53% - one of the best from the literature) is not statistically significant (p=0.4780). Five-years survival was 100% for typical and atypical carcinoids – the best published. We found lymph node metastasis in 2 typical carcinoids, in 2 atypical carcinoids and in 6 SCLCs. Conclusions. For typical and atypical carcinoids, radical resection with lymphadenectomy offers 100% 5-years survival. Early-stage SCLC may benefit from radical resection; lymph node dissection is mandatory because of the well-known precocious lymphatic dissemination.

Keywords: neuroendocrine lung tumors, radical resection, lymphadenectomy, lymph node dissection, carcinoid, small-cell lung cancer.

Correspondence: Natalia Motas MD, PhD, “Prof.Dr.Al.Trestioreanu” Institute of Oncology, Clinic of Thoracic Surgery, Sos.Fundeni 252, Bucharest, 022328, Romania, E-mail: natalia.motas@gmail.com